This factor excludes basal cell skin cancer except for melanoma. Cancer is a major factor for developing
VTEIncidence of venous thromboembolism in patients undergoing surgical treatment for malignancy by type of neoplasm: An analysis of ACS-NSQIP data from 2005 to 2010
Caroline E Reinke 1, Giorgos C Karakousis, Rachel A Hadler, Jeffrey A Drebin, Douglas L Fraker, Rachel R Kelz
PMID: 22828139. DOI: 10.1016/j.surg.2012.05.003
Abstract
Introduction: This study investigates the incidence, relative risk, and adjusted odds ratio of venous thromboembolism (VTE) among patients with malignant neoplasms compared with those with benign neoplasms, as well as the incidence of outpatient VTE diagnosis.
Methods: We performed a retrospective cohort study of patients in the ACS-NSQIP database from 2005 to 2010 with a postoperative diagnosis of neoplasm. The incidence of 30-day VTE, post-VTE death, the incidence of postdischarge VTE diagnosis, and the relative risk of postoperative VTE was calculated by cancer site. Logistic regression was used to calculate an independent odds ratio for each neoplasm site, adjusting for age, gender, body mass index, and operative time.
Results: Of 208,200 patients, 159,752 had a malignant diagnosis of the sites of interest and 48,448 had benign/carcinoma in situ neoplasms. The incidence, relative risk, and odds ratio of 30-day VTE varied substantially by site of malignancy. The absolute incidence of outpatient VTE diagnosis varied by site and percent of VTE diagnosed as an outpatient was found to increase over time.
Conclusion: Recommendations for VTE prophylaxis and duration of VTE prophylaxis for patients undergoing operations may benefit from tailoring to the specific type of malignancy. The increasing percentage of VTE events diagnosed as an outpatient may impact hospitals substantially as financial penalties for readmission are enacted.
Reference:
Surgery. 2012 Aug;152(2):186-92. doi: 10.1016/j.surg.2012.05.003.
Incidence of venous thromboembolism and its effect on survival among patients with common cancers
Helen K Chew 1, Theodore Wun, Danielle Harvey, Hong Zhou, Richard H White
PMID: 16505267. DOI: 10.1001/archinte.166.4.458
Abstract
Background: The incidence of venous thromboembolism after diagnosis of specific cancers and the effect of thromboembolism on survival are not well defined.
Methods: The California Cancer Registry was linked to the California Patient Discharge Data Set to determine the incidence of venous thromboembolism among cancer cases diagnosed between 1993 and 1995. The incidence and timing of thromboembolism within 1 and 2 years of cancer diagnosis and the risk factors associated with thromboembolism and death were determined.
Results: Among 235 149 cancer cases, 3775 (1.6%) were diagnosed with venous thromboembolism within 2 years, 463 (12%) at the time cancer was diagnosed and 3312 (88%) subsequently. In risk-adjusted models, metastatic disease at the time of diagnosis was the strongest predictor of thromboembolism. Expressed as events per 100 patient-years, the highest incidence of thromboembolism occurred during the first year of follow-up among cases with metastatic-stage pancreatic (20.0), stomach (10.7), bladder (7.9), uterine (6.4), renal (6.0), and lung (5.0) cancer. Adjusting for age, race, and stage, diagnosis of thromboembolism was a significant predictor of decreased survival during the first year for all cancer types (hazard ratios, 1.6-4.2; P<.01).
Conclusions: The incidence of venous thromboembolism varied with cancer type and was highest among patients initially diagnosed with metastatic-stage disease. The incidence rate of thromboembolism decreased over time. Diagnosis of thromboembolism during the first year of follow-up was a significant predictor of death for most cancer types and stages analyzed. For some types of cancer, the incidence of thromboembolism was sufficiently high to warrant prospective clinical trials of primary thromboprophylaxis.
Reference:
Arch Intern Med. 2006 Feb 27;166(4):458-64. doi: 10.1001/archinte.166.4.458.