Risk factors for incident venous thromboembolism in active cancer patients: A population based case–control study. Issue 139 (March 2016)

• Record Type: Journal Article
• Authors: Ashrani, Aneel A.; Gullerud, Rachel E.; Petterson, Tanya M.; Marks, Randolph S.; Bailey, Kent R.; Heit, John A.
• Is Part Of: Thrombosis research. Issue 139(2016)
• Page Start: 29
• Page End: 37
• Publication Date: 2016-03
• Subjects: Venous thromboembolism -- Cancer -- Epidemiology -- Risk factors -- Deep vein thrombosis -- Pulmonary embolism; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2016.01.002
• Languages: English
• ISSNs: 0049-3848

Abstract

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/m 2 (OR = 1.9) or ≥ 35 kg/m 2 (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 × 10 9 /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. Highlights: We tested cancer and non-cancer characteristics as predictors of cancer-associated VTE. Cancer site, stage, liver metastasis, chemotherapy, and progestin increased VTE risk. BMI, hospitalization, central venous catheter and infection increased VTE risk. These characteristics can be used to identify high VTE-risk active cancer patients.