Risk factors for incident venous thromboembolism in active cancer patients: A population based case-control study

Aneel Arjun Ashrani, Rachel E. Gullerud, Tanya M. Petterson, Randolph Stuart Marks, Kent R Bailey, John A. Heit

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26 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)29-37
Number of pages9
JournalThrombosis Research
Volume139
DOIs
StatePublished - Mar 1 2016

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Keywords

  • Cancer
  • Deep vein thrombosis
  • Epidemiology
  • Pulmonary embolism
  • Risk factors
  • Venous thromboembolism

ASJC Scopus subject areas

  • Hematology

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