Epidemiology of first and recurrent venous thromboembolism in patients with active cancer A population-based cohort study
Epidemiology of first and recurrent venous thromboembolism in patients with active cancer A population-based cohort study
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DOI：
10.1160/th15-08-0686
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发表时间：
2017-01-01
影响因子：
6.7
通讯作者：
Martinez, Carlos
中科院分区：
文献类型：
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作者：
Cohen, Alexander T.;Katholing, Anja;Martinez, Carlos
关于活动性癌症患者静脉血栓栓塞（VTE）发生率的人群研究有限。进行了一项观察性队列研究，以估计首次和复发性VTE的发生率。源人群包括2001年至2011年期间英国临床实践研究数据链中的所有患者，以及关于住院和死亡原因的其他信息。VTE之前或之后90天内的癌症相关临床诊断或治疗构成活动性癌症相关VTE。估计了活动性癌症患者中首次VTE的发生率和首次VTE事件后10年观察期内复发性VTE的发生率。还计算了全因死亡率以及年龄和性别特异性死亡率的发生率。共有6，592例活动性癌症相关VTE，共计112，738例癌症相关观察人年。活动性癌症患者首次静脉血栓栓塞的发生率为每100人年5.8例（95%置信区间5.7-6.0）。在591例患者中观察到首次VTE复发。复发的总体发生率为9.6（95%置信区间8.8-10.4）/100人-年，前6个月的峰值为22.1。初始肺栓塞和初始深静脉血栓形成后的复发率相似。VTE后的死亡风险相当大，1年后死亡率为64.5%，10年后为88.1%。活动性癌症患者的VTE很常见，并与高复发率和死亡率相关。需要努力预防静脉血栓栓塞和减少复发，特别是在静脉血栓栓塞诊断后的第一年。
Population studies on the incidence of venous thromboembolism (VTE) in patients with active cancer are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The source population consisted of all patients in the UK Clinical Practice Research Datalink, with additional information on hospitalisation and cause of death, between 2001 and 2011. A cancer-related clinical diagnosis or therapy within the 90 days before or after a VTE constituted an active-cancer-associated VTE. Incidence rates of first VTE among patients with active cancer and incidence rates of recurrent VTE during the 10-year observational period after a first VTE event were estimated. Incidence rates of all-cause mortality and age and gender-specific mortality were also calculated. There were 6,592 active-cancer-associated VTEs with a total of 112,738 cancer-associated person-years of observation. The incidence rate of first VTE in patients with active cancer was 5.8 (95 % confidence interval 5.7-6.0) per 100 person-years. A first VTE recurrence was observed in 591 patients. The overall incidence rate for recurrence was 9.6 (95% confidence interval 8.8-10.4) per 100 person-years, with a peak at 22.1 in the first six months. Recurrence rates were similar after initial pulmonary embolism and after initial deep-vein thrombosis. The mortality risk after VTE was considerable, with 64.5% mortality after one year and 88.1 % after 10 years. VTE in patients with active cancer is common and associated with high recurrence and mortality rates. Efforts are needed to prevent VTE and reduce recurrence, especially in the first year after VTE diagnosis.