Outcomes after venous thromboembolism in patients with gastric cancer: Analysis of the RIETE Registry
Outcomes after venous thromboembolism in patients with gastric cancer: Analysis of the RIETE Registry
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DOI：
10.1177/1358863x19893432
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发表时间：
2020-01-30
影响因子：
3.5
通讯作者：
Monreal, Manuel
中科院分区：
文献类型：
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作者：
Majmudar, Kaushal;Golemi, Iva;Monreal, Manuel
胃癌是全球第五大最常见的恶性肿瘤。静脉血栓栓塞是胃癌患者死亡的独立预测因子。我们的目的是描述发生静脉血栓栓塞的胃癌患者的死亡率、血栓复发和出血并发症的相关因素。从2001年到2018年，我们将612例胃癌和静脉血栓栓塞患者纳入了RIETE （Registro Informatizado de la Enfermedad troboembolica）登记。我们使用Cox比例风险比和Fine-Gray模型来定义与结果相关的因素。6个月总死亡率为44.4%。与6个月死亡率增加相关的因素包括不活动（HR 1.8, 95% CI 1.3-2.4; p < 0.001）、贫血（HR 1.4, 95% CI 1.1-1.8; p < 0.02）和白细胞增多（HR 1.8, 95% CI 1.4-2.3; p < 0.001）。6.5%的患者出现血栓复发，8.5%的患者出现大出血并发症。男性是血栓复发的主要影响因素（HR 2.1, 95% CI 1.1 ~ 4.0, p < 0.02），血红蛋白低于10 g/dL （HR 1.6, 95% CI 1.05 ~ 2.50, p = 0.03）是出血的主要影响因素。总之，发生静脉血栓形成的胃癌患者死亡的可能性非常高。在这一人群中，低血红蛋白与不良预后相关。
Gastric cancer is the fifth most common malignancy worldwide. Venous thromboembolism is an independent predictor of death among patients with gastric cancer. We aimed to describe the factors associated with mortality, thrombosis recurrence, and bleeding complications in patients with gastric cancer who develop venous thromboembolism. We included 612 patients with gastric cancer and venous thromboembolism in the Registro Informatizado de la Enfermedad TromboEmbolica (RIETE) registry from 2001 to 2018. We used Cox proportional hazard ratios and a Fine-Gray model to define factors associated with outcomes. The overall mortality at 6 months was 44.4%. Factors associated with increased 6-month mortality included immobility (HR 1.8, 95% CI 1.3-2.4; p < 0.001), anemia (HR 1.4, 95% CI 1.1-1.8; p < 0.02), and leukocytosis (HR 1.8, 95% CI 1.4-2.3; p < 0.001). Recurrent thrombosis occurred in 6.5% of patients and major bleeding complications in 8.5% of the cohort. Male sex was the main factor associated with thrombosis recurrence (HR 2.1, 95% CI 1.1-4.0; p < 0.02) and hemoglobin below 10 g/dL (HR 1.6, 95% CI 1.05-2.50; p = 0.03) the main factor associated with bleeding. In conclusion, patients with gastric cancer who develop venous thrombosis have a very high likelihood of death. Low hemoglobin in this population is associated with poor outcomes.