Cancer-associated venous thromboembolism in Israel: Incidence, risk factors, treatment, and health care utilization in a population based cohort study.
anticoagulation
cancer
health care resource utilization
risk assessment
venous thromboembolism
Journal
Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
26
07
2021
revised:
18
11
2021
accepted:
28
12
2021
entrez:
27
5
2022
pubmed:
28
5
2022
medline:
28
5
2022
Statut:
epublish
Résumé
Recent international guidelines recommend thromboprophylaxis in patients with cancer at intermediate-high venous thromboembolism (VTE) risk. We aimed to assess the current incidence, risk factors and management of cancer-associated VTE and associated health care resource utilization in a 2.5-million-member state-mandated health service in Israel. Patients aged ≥18 years with newly diagnosed cancer, initiating systemic anticancer treatment from 2010 through 2018 were identified from the Israel National Cancer Registry. The index date was fixed as the first day of systemic anticancer treatment. The cumulative VTE incidence from the first day of systemic anticancer treatment and the respective hazard ratios for VTE risk factors were calculated at 12 months of follow-up. Health care resource utilization (primary care physician, emergency room, and hospital visits) during the study period was compared between patients with and without VTE. A total of 15 388 patients were included, and 338 had VTE with a 12-month cumulative incidence of 2.2% (95% confidence interval, 1.96%-2.43%). In a multivariable model, older age, higher comorbidity index, intermediate-high-risk Khorana score, certain malignancy types, and chemotherapy were significantly associated with an increased VTE risk in the year after initiating anticancer treatment. Compared with matched controls, the VTE subcohort were more likely to be hospitalized (81.4% vs 35.2%), have longer hospital stays (20.1 days vs 13.1 days), have an emergency room visit (41.5% vs 19.3%), and have a larger number of primary care physician visits (17.6 vs 12.5). Several risk factors, including the Khorana score, were associated with VTE incidence. VTE was associated with long-term use of anticoagulation. Health care utilization was higher in patients with VTE.
Sections du résumé
Background
UNASSIGNED
Recent international guidelines recommend thromboprophylaxis in patients with cancer at intermediate-high venous thromboembolism (VTE) risk.
Objectives
UNASSIGNED
We aimed to assess the current incidence, risk factors and management of cancer-associated VTE and associated health care resource utilization in a 2.5-million-member state-mandated health service in Israel.
Methods
UNASSIGNED
Patients aged ≥18 years with newly diagnosed cancer, initiating systemic anticancer treatment from 2010 through 2018 were identified from the Israel National Cancer Registry. The index date was fixed as the first day of systemic anticancer treatment. The cumulative VTE incidence from the first day of systemic anticancer treatment and the respective hazard ratios for VTE risk factors were calculated at 12 months of follow-up. Health care resource utilization (primary care physician, emergency room, and hospital visits) during the study period was compared between patients with and without VTE.
Results
UNASSIGNED
A total of 15 388 patients were included, and 338 had VTE with a 12-month cumulative incidence of 2.2% (95% confidence interval, 1.96%-2.43%). In a multivariable model, older age, higher comorbidity index, intermediate-high-risk Khorana score, certain malignancy types, and chemotherapy were significantly associated with an increased VTE risk in the year after initiating anticancer treatment. Compared with matched controls, the VTE subcohort were more likely to be hospitalized (81.4% vs 35.2%), have longer hospital stays (20.1 days vs 13.1 days), have an emergency room visit (41.5% vs 19.3%), and have a larger number of primary care physician visits (17.6 vs 12.5).
Conclusion
UNASSIGNED
Several risk factors, including the Khorana score, were associated with VTE incidence. VTE was associated with long-term use of anticoagulation. Health care utilization was higher in patients with VTE.
Identifiants
pubmed: 35619639
doi: 10.1002/rth2.12653
pii: S2475-0379(22)01206-7
pmc: PMC9126988
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e12653Informations de copyright
© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).
Références
Urol Oncol. 2020 Nov;38(11):849.e19-849.e23
pubmed: 32616422
Blood. 2010 Dec 9;116(24):5377-82
pubmed: 20829374
J Clin Oncol. 2018 Jul 10;36(20):2017-2023
pubmed: 29746227
Thromb Res. 2016 Sep;145:51-3
pubmed: 27485998
Pharmacoepidemiol Drug Saf. 2011 Jun;20(6):560-6
pubmed: 21387461
N Engl J Med. 2020 Apr 23;382(17):1599-1607
pubmed: 32223112
Thromb Haemost. 2002 Apr;87(4):575-9
pubmed: 12008937
J Thromb Haemost. 2021 Jan;19(1):212-220
pubmed: 33104289
Blood. 2002 Nov 15;100(10):3484-8
pubmed: 12393647
Lancet Haematol. 2018 Jul;5(7):e273-e274
pubmed: 29885941
Eur J Epidemiol. 2003;18(12):1143-6
pubmed: 14758871
Clinicoecon Outcomes Res. 2013;5:101-8
pubmed: 23430767
Blood. 2021 Apr 15;137(15):2103-2113
pubmed: 33270827
Thromb Res. 2017 Feb;150:86-89
pubmed: 28064037
Chest. 2016 Feb;149(2):315-352
pubmed: 26867832
Jpn J Clin Oncol. 2020 Oct 22;50(11):1246-1253
pubmed: 32715307
Ann Oncol. 2011 Sep;22 Suppl 6:vi85-92
pubmed: 21908511
Blood. 2008 May 15;111(10):4902-7
pubmed: 18216292
Clin Appl Thromb Hemost. 2017 Sep;23(6):532-541
pubmed: 27899520
Cancer Invest. 2009;27 Suppl 1:63-74
pubmed: 19291526
Lancet Oncol. 2019 Oct;20(10):e566-e581
pubmed: 31492632
Arch Intern Med. 2004 Aug 9-23;164(15):1653-61
pubmed: 15302635
J Clin Epidemiol. 1992 Jun;45(6):613-9
pubmed: 1607900
Lung Cancer. 2012 Dec;78(3):253-8
pubmed: 23026639
Cureus. 2020 Apr 29;12(4):e7883
pubmed: 32489737
Lancet Oncol. 2016 Oct;17(10):e452-e466
pubmed: 27733271
J Thromb Haemost. 2007 Mar;5(3):632-4
pubmed: 17319909
Br J Cancer. 2010 Sep 28;103(7):947-53
pubmed: 20842120
Int J Cardiol. 2011 Nov 3;152(3):345-9
pubmed: 20826019
Br J Haematol. 2015 Sep;170(5):640-8
pubmed: 26114207
J Clin Oncol. 2020 Feb 10;38(5):496-520
pubmed: 31381464
N Engl J Med. 2000 Dec 21;343(25):1846-50
pubmed: 11117976
Blood Adv. 2021 Feb 23;5(4):927-974
pubmed: 33570602
N Engl J Med. 2019 Feb 21;380(8):711-719
pubmed: 30511879
J Thromb Haemost. 2017 Dec;15(12):2352-2360
pubmed: 29027356
N Engl J Med. 2019 Feb 21;380(8):720-728
pubmed: 30786186
Blood. 2021 Apr 8;137(14):1959-1969
pubmed: 33171494
Cochrane Database Syst Rev. 2020 Dec 18;12:CD008500
pubmed: 33337539
Res Pract Thromb Haemost. 2022 May 23;6(4):e12653
pubmed: 35619639
Res Pract Thromb Haemost. 2017 May 30;1(1):14-22
pubmed: 30046670
J Thromb Haemost. 2019 Oct;17(10):1772-1778
pubmed: 31353841
Haematologica. 2019 Jun;104(6):1277-1287
pubmed: 30606788
Oncologist. 2013;18(12):1321-9
pubmed: 24212499
Arch Intern Med. 2000 Mar 27;160(6):809-15
pubmed: 10737280
Cancer. 2007 Nov 15;110(10):2339-46
pubmed: 17918266
Med Care. 1988 Aug;26(8):814-23
pubmed: 3398608
Arch Intern Med. 2006 Feb 27;166(4):458-64
pubmed: 16505267
Pharmacoepidemiol Drug Saf. 2010 Jun;19(6):596-603
pubmed: 20140892
Cochrane Database Syst Rev. 2016 Dec 01;12:CD008500
pubmed: 27906452
PLoS One. 2015 Aug 20;10(8):e0135834
pubmed: 26292280
N Engl J Med. 2018 Feb 15;378(7):615-624
pubmed: 29231094
J Clin Oncol. 2013 Jun 10;31(17):2189-204
pubmed: 23669224
J Med Econ. 2019 Nov;22(11):1134-1140
pubmed: 31106638
Thromb Haemost. 2020 May;120(5):847-856
pubmed: 32369855
J Clin Oncol. 2006 Jan 20;24(3):484-90
pubmed: 16421425
Thromb Res. 2015 Apr;135(4):616-20
pubmed: 25613924
Thromb Res. 2019 Sep;181:1-9
pubmed: 31302473
Thromb Res. 2018 Apr;164 Suppl 1:S70-S76
pubmed: 29395243
Curr Oncol. 2018 Oct;25(5):329-337
pubmed: 30464682
Blood. 2016 Feb 18;127(7):849-57; quiz 953
pubmed: 26574606
Eur J Cancer. 2013 Apr;49(6):1404-13
pubmed: 23146958
J Natl Compr Canc Netw. 2018 Nov;16(11):1289-1303
pubmed: 30442731
Br J Cancer. 2018 Apr;118(8):1056-1061
pubmed: 29588512
Am J Med. 2006 Jan;119(1):60-8
pubmed: 16431186