Incidence of venous thromboembolism in patients with cancer - A cohort study using linked United Kingdom databases
Incidence of venous thromboembolism in patients with cancer - A cohort study using linked United Kingdom databases
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DOI：
10.1016/j.ejca.2012.10.021
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发表时间：
2013-04-01
影响因子：
8.4
通讯作者：
Grainge, Matthew J.
中科院分区：
文献类型：
--
作者：
Walker, Alex J.;Card, Tim R.;Grainge, Matthew J.
背景资料：准确的人口为基础的数据是需要在不同的癌症患者的静脉血栓栓塞（VTE）的发病率，以告知指南，住院和门诊癌症患者应接受静脉血栓栓塞prophylaxy.Methods：我们进行了一项队列研究，使用的数据从临床实践研究数据链接，链接到医院发病统计，癌症登记数据和国家统计局的死亡原因数据。我们分别测定了24个癌症部位的VTE发病率（例/1000人-年）。为了确定相对风险，将发病率与无癌症记录的频率匹配对照组（按年龄）进行比较。在3352名癌症患者和6353名对照者中诊断出VTE新发病例。所有癌症中VTE的绝对发生率为13.9/1000人-年（95%置信区间[CI] 13.4-14.4），对应于癌症患者和普通人群之间的年龄、性别和日历年校正风险比为4.7（CI 4.5-4.9）。癌症部位的比率差异很大（范围：胰腺癌98（CI 80-119）至3.1（CI 1.5-6.5）甲状腺癌），年龄（范围：80岁以上患者为16.9，30岁以下患者为4.9）和诊断时间（范围：前三个月75至诊断后> 1年8.4）。解释：静脉血栓栓塞与癌症密切相关，但每年的发病率因癌症部位、与诊断的接近程度和年龄而有很大差异。预防指南应考虑到癌症部位，这种干预也应针对诊断后的三个月。(C)2012爱思唯尔有限公司保留所有权利。
Background: Accurate population-based data are needed on the incidence of venous thromboembolism (VTE) in patients with different cancers in order to inform guidelines on which hospitalised and ambulatory cancer patients should receive VTE prophylaxis.Methods: We conducted a cohort study using data from the Clinical Practice Research Data-link, linked to Hospital Episode Statistics, Cancer Registry data and Office for National Statistics cause of death data. We determined the incidence rates (cases per 1000 person-years) of VTE separately for 24 cancer sites. To determine relative risk, incidence rates were compared to frequency-matched controls (by age) with no record of cancer.Findings: We identified 83,203 cancer patients and 577,207 controls. New cases of VTE were diagnosed in 3352 cancer patients, and 6353 controls. The absolute rate of VTE in all cancers was 13.9 per 1000 person-years (95% confidence interval [CI] 13.4-14.4), corresponding to an age, sex and calendar year adjusted hazard-ratio of 4.7 (CI 4.5-4.9) between cancer patients and the general population. Rates varied greatly by cancer site (range; 98 (CI 80-119) in pancreatic cancer to 3.1 (CI 1.5-6.5) in thyroid cancer), age (range; 16.9 for patients over 80 years to 4.9 for those under 30 years) and time from diagnosis (range; 75 in the first three months to 8.4, > 1 year after diagnosis).Interpretation: VTE is strongly linked to cancer, but the annual rate varies greatly by cancer site, proximity to diagnosis and age. Prophylaxis guidelines should take account of cancer site and such intervention should also be targeted towards the three months following diagnosis. (C) 2012 Elsevier Ltd. All rights reserved.