TY - JOUR
T1 - Risk factors for incident venous thromboembolism in active cancer patients
T2 - A population based case-control study
AU - Ashrani, Aneel A.
AU - Gullerud, Rachel E.
AU - Petterson, Tanya M.
AU - Marks, Randolph S.
AU - Bailey, Kent R.
AU - Heit, John A.
N1 - Publisher Copyright:
© 2016 Elsevier Ltd. All rights reserved.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background Independent risk factors for cancer-associated incident venous thromboembolism (VTE) and their magnitude of risk are not fully characterized. Aim To identify non-cancer and cancer-specific risk factors for cancer-associated incident VTE. Methods In a population-based retrospective case-control study, we used Rochester Epidemiology Project and Mayo Clinic Cancer Registry resources to identify all Olmsted County, MN residents with active cancer-associated incident VTE, 1973-2000 (cases; n = 570) and 1-3 residents with active cancer matched to each case on age, sex, date and duration of active cancer (controls; n = 604). Using conditional logistic regression, we tested cancer and non-cancer characteristics for an association with VTE, including a cancer site VTE risk score. Results In the multivariable model, higher cancer site VTE risk score (OR = 1.4 per 2-fold increase), cancer stage ≥ 2 (OR = 2.2), liver metastasis (OR = 2.7), chemotherapy (OR = 1.8) and progesterone use (OR = 2.1) were independently associated with VTE, as were BMI < 18.5 kg/m2 (OR = 1.9) or ≥ 35 kg/m2 (OR = 4.0), hospitalization (OR = 7.9), nursing home confinement (OR = 4.7), central venous (CV) catheter (OR = 8.5) and any recent infection (OR = 1.7). In a subgroup analysis, platelet count ≥ 350 × 109/L at time of cancer diagnosis was marginally associated with VTE (OR = 2.3, p = 0.07). Conclusion Cancer site, cancer stage ≥ 2, liver metastasis, chemotherapy, progesterone, being underweight or obese, hospitalization/nursing home confinement, CV catheter, and infection are independent risk factors for incident VTE in active cancer patients.
AB - Background Independent risk factors for cancer-associated incident venous thromboembolism (VTE) and their magnitude of risk are not fully characterized. Aim To identify non-cancer and cancer-specific risk factors for cancer-associated incident VTE. Methods In a population-based retrospective case-control study, we used Rochester Epidemiology Project and Mayo Clinic Cancer Registry resources to identify all Olmsted County, MN residents with active cancer-associated incident VTE, 1973-2000 (cases; n = 570) and 1-3 residents with active cancer matched to each case on age, sex, date and duration of active cancer (controls; n = 604). Using conditional logistic regression, we tested cancer and non-cancer characteristics for an association with VTE, including a cancer site VTE risk score. Results In the multivariable model, higher cancer site VTE risk score (OR = 1.4 per 2-fold increase), cancer stage ≥ 2 (OR = 2.2), liver metastasis (OR = 2.7), chemotherapy (OR = 1.8) and progesterone use (OR = 2.1) were independently associated with VTE, as were BMI < 18.5 kg/m2 (OR = 1.9) or ≥ 35 kg/m2 (OR = 4.0), hospitalization (OR = 7.9), nursing home confinement (OR = 4.7), central venous (CV) catheter (OR = 8.5) and any recent infection (OR = 1.7). In a subgroup analysis, platelet count ≥ 350 × 109/L at time of cancer diagnosis was marginally associated with VTE (OR = 2.3, p = 0.07). Conclusion Cancer site, cancer stage ≥ 2, liver metastasis, chemotherapy, progesterone, being underweight or obese, hospitalization/nursing home confinement, CV catheter, and infection are independent risk factors for incident VTE in active cancer patients.
KW - Cancer
KW - Deep vein thrombosis
KW - Epidemiology
KW - Pulmonary embolism
KW - Risk factors
KW - Venous thromboembolism
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U2 - 10.1016/j.thromres.2016.01.002
DO - 10.1016/j.thromres.2016.01.002
M3 - Article
C2 - 26916293
AN - SCOPUS:84960075187
SN - 0049-3848
VL - 139
SP - 29
EP - 37
JO - Thrombosis research
JF - Thrombosis research
ER -