The impact of venous thromboembolism on risk of death or hemorrhage in older cancer patients.
The impact of venous thromboembolism on risk of death or hemorrhage in older cancer patients.
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DOI：
10.1007/s11606-006-0019-x
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发表时间：
2007-03
影响因子：
5.7
通讯作者：
Krumholz, Harlan M.
中科院分区：
文献类型：
--
作者：
Gross, Cary P.;Galusha, Deron H.;Krumholz, Harlan M.
在老年癌症患者中，静脉血栓栓塞（VTE）及其治疗增加死亡或大出血风险的程度尚不确定。确定老年癌症患者队列中VTE的患病率，以及VTE增加死亡或大出血风险的程度。我们对相关的监测、流行病学和最终结果癌症登记和医疗保险行政索赔数据进行了回顾性队列研究。纳入1995年至1999年期间诊断的10种浸润性癌症中的任何一种的患者;自变量是与癌症诊断同时诊断的VTE。结果包括癌症诊断后第一年内的大出血和全因死亡率;总体而言，约1%的癌症诊断患者同时诊断出VTE。在调整社会人口统计学因素和癌症分期和分级后，伴随VTE与10种癌症类型中8种的死亡风险相对增加相关;大多数癌症类型的风险增加倾向于20-40%。大约16.8%（95%置信区间[CI] 14.9-18.8%）合并VTE的患者和7.9%（95% CI 7.7-8.0%）未合并VTE的患者在癌症诊断后一年内发生了大出血（P值<0.001）。与VTE相关的过度出血风险在不同癌症类型中差异很大，范围从无显著过度（肾癌和子宫癌）到11.5%（淋巴瘤）。伴随性静脉血栓栓塞不仅是老年癌症患者死亡风险增加的标志物和潜在介质，而且静脉血栓栓塞患者发生大出血的风险显著增加。
Among older cancer patients, there is uncertainty about the degree to which venous thromboembolism (VTE) and its treatment increase the risk of death or major hemorrhage. To determine the prevalence of VTE in a cohort of older cancer patients, as well as the degree to which VTE increased the risk of death or major hemorrhage. We conducted a retrospective cohort study of linked Surveillance, Epidemiology, and End Results cancer registry and Medicare administrative claims data. Patients with any of ten invasive cancers diagnosed during 1995 through 1999 were included; the independent variable was VTE diagnosed concomitantly with cancer diagnosis. Outcomes included major hemorrhage during the first year after cancer diagnosis and all-cause mortality; Overall, about 1% of patients who were diagnosed with cancer also had a VTE diagnosed concomitantly. After adjusting for sociodemographic factors and cancer stage and grade, concomitant VTE was associated with a relative increase in the risk of death for 8 of the 10 cancer types; the increase in risk tended to range 20–40% across most cancer types. Approximately 16.8% (95% confidence interval [CI] 14.9–18.8%) of patients with a concomitant VTE and 7.9% (95% CI 7.7–8.0%) of patients without a VTE experienced a major hemorrhage during the year after cancer diagnosis (P value <.001). The excess risk of hemorrhage associated with VTE varied substantially across cancer types, ranging from no significant excess (kidney and uterine cancer) to 11.5% (lymphoma). Concomitant VTE is not only a marker and potential mediator of increased risk of death among older cancer patients, but patients with a VTE have a marked increased risk of major hemorrhage.
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影响因子：
158.5
作者：
HSIA, DC;KRUSHAT, WM;KUSSEROW, RP
通讯作者：
KUSSEROW, RP
影响因子：
--
作者：
KNIFFIN, WD;BARON, JA;ANDERSON, FA
通讯作者：
ANDERSON, FA
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
3
作者：
Baker, DW;Einstadter, D;Cebul, RD
通讯作者：
Cebul, RD
影响因子：
2.4
作者：
Rogers, LR
通讯作者：
Rogers, LR