Risk factors for venous thromboembolic events in pediatric surgical patients: Defining indications for prophylaxis

2018 ◽  
Vol 53 (10) ◽  
pp. 1996-2002 ◽  
Author(s):  
Sarah B. Cairo ◽  
Timothy B. Lautz ◽  
Beverly A. Schaefer ◽  
Guan Yu ◽  
Hibbut-ur-Rauf Naseem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Patients ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

Risk Factors for Venous Thromboembolic Events in Pediatric Surgical Patients: Defining When Prophylaxis Is Indicated

2017 ◽  
Vol 225 (4) ◽  
pp. e139
Author(s):  
Sarah B. Cairo ◽  
Hibbut-Ur-Rauf Naseem ◽  
David H. Rothstein
Keyword(s):  
Risk Factors ◽  
Surgical Patients ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

Venous thromboembolic events in T-cell lymphoma patients: Incidence, risk factors and clinical features

2021 ◽  
Vol 103 ◽  
pp. 106537
Author(s):  
Yingxia Lan ◽  
Jinqiu Guan ◽  
Jia Zhu ◽  
Juan Wang ◽  
Mengzhen Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Cell ◽  
Clinical Features ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Incidence Risk

scholarly journals Venous Thromboembolic Events in Diffuse Large B Cell Lymphoma Patients: Risk Factors and Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3611-3611
Author(s):  
Sabarish Ram Ayyappan ◽  
Vinita Gupta ◽  
Akiva Diamond ◽  
Brenda Cooper ◽  
Ben K. Tomlinson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cumulative Incidence ◽  
Cell Lymphoma ◽  
Statistical Significance ◽  
B Cell Lymphoma ◽  
Thromboembolic Events ◽  
Large B Cell Lymphoma ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Large B Cell

Abstract Venous thromboembolic events (VTE) are common after the diagnosis of lymphoma. Although various risk factors have been associated with VTE in cancer patients, there is no specific VTE risk prediction score for diffuse large B cell lymphoma (DLBCL) patients. The Khorana score is a prediction-model of VTE in cancer patients receiving chemotherapy that incorporates clinical and laboratory parameters. We evaluated the risk factors for VTE, the effect of VTE on the outcomes of DLBCL patients and the utility of the Khorana score in DLBCL patients. Methods: We searched the Hematologic Malignancies Database of University Hospitals Seidman Cancer Center for newly diagnosed DLBCL patients between 2002 and 2014. Data on patient characteristics including risk factors, disease characteristics, treatment, outcomes and VTE was collected. The Khorana score was calculated using clinical (disease type, body mass index) and laboratory (hemoglobin level, platelet and leukocyte count) parameters. Risk factors identified as having statistical significance on univariate Cox proportional hazards analysis (p <0.05) were selected for multivariate analysis. Cumulative incidence (with death as competing risk) was used to estimate the incidence of VTE. Overall survival (OS) and progression free survival (PFS) were calculated using the Kaplan-Meier method; comparison between groups was done using the log-rank test. Results: Four hundred DLBCL patients were included for analysis. Median age at diagnosis was 63 with 235 patients above the age of 60. Two hundred and thirty seven patients (59.3 %) had advanced stage at diagnosis and 14 patients (3.5%) had a prior history of VTE. Baseline characteristics are listed in Table 1. Sixty percent of patients had a Khorana score of 1 with no risk factors in addition to the diagnosis of lymphoma. At median follow up of 33 months, 70 patients (18%) presented a VTE, with 1-year and 3-year cumulative incidence of 10.1% (95% CI 7.1-13.6) and 14% (95 % CI 10.8-18), respectively. Fifty-seven VTE (81% of all VTEs) were diagnosed in patients with active disease (at diagnosis, relapse or during active therapy). The Khorana score separated DLBCL patients in three VTE risk groups: intermediate (1 point), high (2 points) and very high (3 or more points) with 1 year cumulative incidence of VTE of 6.4%, 11.6% and 22.2%, respectively (p = 0.009) (Figure 1). On univariate analysis, bone involvement by lymphoma, elevated corrected calcium (>12g/dL), increased white cell count (>11,000/mcl), hemoglobin (<10g/dL), monocytosis (>800/mcl) and chromosomal translocations involving MYC presented statistically significant increases in hazard of VTE (Table 2). On multivariate analysis only bone involvement (p=0.017) and anemia (p=0.035) retained statistical significance as risk factors for VTE. Three-year OS for patients presenting with VTE within 1 year of DLBCL diagnosis was 46.7 % (95% CI 30-63.3) vs. 72.3% (95% CI 67.4-77.3) in subjects without early VTE (p=0.05) (Figure 2). Presence of VTE at any time after DLBCL diagnosis was also associated with worse OS rates, with estimated 3-year OS of 52.2 % (95 % CI 39.8-64.7) for subjects experiencing VTE and 74 % (95 % CI 69-79) for those without VTE after DLBCL diagnosis (p<0.0001). Conclusion: Venous thromboembolic events are common after diagnosis of DLBCL and are associated with worsened outcomes. The Khorana score is capable of identifying patient subgroups with increased risk of VTE. Additional parameters associated with aggressive disease and advanced stages could further help in VTE risk stratification for selection of patients who may benefit from antithrombotic prophylaxis. Prospective validation of VTE risk assessments and clinical trials of VTE prevention are needed in this high=risk population. Disclosures Caimi: Gilead: Consultancy; Novartis: Consultancy; Genentech: Speakers Bureau; Roche: Research Funding.

Incidence and risk factors of venous thromboembolic events after resection of various brain tumors

2021 ◽  
Vol 85 (3) ◽  
pp. 63
Author(s):  
A.V. Bervitskiy ◽  
G.I. Moisak ◽  
V.E. Guzhin ◽  
E.V. Amelina ◽  
A.V. Kalinovskiy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumors ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

scholarly journals Venous thromboembolic events stratified by number of risk factors in patients with metastatic germ cell tumours undergoing first-line chemotherapy

2020 ◽  
Vol 19 ◽  
pp. e398-e399
Author(s):  
C. Fankhauser ◽  
B. Tran ◽  
J.M. Ruiz-Morales ◽  
E. Gonzalez-Billalabeitia ◽  
A. Patrikidou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Germ Cell ◽  
Germ Cell Tumours ◽  
Thromboembolic Events ◽  
First Line ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Line Chemotherapy

Is prolonged immobilization a risk factor for symptomatic venous thromboembolism in elderly bedridden patients?

2004 ◽  
Vol 91 (03) ◽  
pp. 538-543 ◽  
Author(s):  
Ora Paltiel ◽  
Michael Bursztyn ◽  
Moshe Gatt
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Early Period ◽  
Thromboembolic Events ◽  
Historical Cohort ◽  
Increased Risk ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Prolonged Immobilization ◽  
The Impact

SummaryProlonged immobilization and advanced age are considered to be important risk factors for venous thromboembolism (VTE). Nevertheless, the need for VTE prophylaxis in long-term bedridden patients is not known. To assess whether very prolonged immobilization (i.e. over three months) carries an increased risk for clinically apparent VTE, we performed a historical-cohort study of nursing home residents during a ten-year period. Data concerning patient’s mobility and incidence of overt deep vein thrombosis or pulmonary embolism were registered. The mean resident age was 85 ± 8.4 years. Eighteen mobile and eight immobile patients were diagnosed with clinically significant thromboembolic events, during 1137 and 573 patient-years of follow up, respectively. The incidence of venous thromboembolic events was similar in both chronically immobilized and mobile patient groups, 13.9 and 15.8 per thousand patient years, respectively (p = 0.77). The rate ratio for having a VTE event in the immobilized patient group as compared with the mobile group was 0.88 (95% Confidence Interval (CI) 0.33 to 2.13). When taking into account baseline characteristics, risk factors and death rates by various causes, no differences were found between the two groups. In conclusion, chronically immobile bedridden patients are no more prone to clinically overt venous thromboembolic events than institutionalized mobile patients. Until further studies are performed concerning the impact of very prolonged immobilization on the risk of VTE, there is no evidence to support primary prevention after the first three months of immobilization. Evidence for efficacy or cost effectiveness beyond this early period is not available.

Epidemiology and pathophysiology of venous thromboembolism: similarities with atherothrombosis and the role of inflammation

2015 ◽  
Vol 113 (06) ◽  
pp. 1176-1183 ◽  
Author(s):  
Nicoletta Riva ◽  
Marco P. Donadini ◽  
Walter Ageno
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Major Trauma ◽  
Thromboembolic Events ◽  
Prothrombotic State ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Potential Link ◽  
Predisposing Conditions

SummaryVenous thromboembolism (VTE) is a multifactorial disease. Major provoking factors (e. g. surgery, cancer, major trauma, and immobilisation) are identified in 50–60 % of patients, while the remaining cases are classified as unprovoked. However, minor predisposing conditions may be detectable in these patients, possibly concurring to the pathophysiology of the disease, especially when co-existing. In recent years, the role of chronic inflammatory disorders, infectious diseases and traditional cardiovascular risk factors has been extensively investigated. Inflammation, with its underlying prothrombotic state, could be the potential link between these risk factors, as well as the explanation for the reported association between arterial and venous thromboembolic events.

scholarly journals Incidence and Risk Factors Related to Symptomatic Venous Thromboembolic Events After Esophagectomy for Cancer

2016 ◽  
Vol 102 (3) ◽  
pp. 979-984 ◽  
Author(s):  
Styliani Mantziari ◽  
Caroline Gronnier ◽  
Arnaud Pasquer ◽  
Johan Gagnière ◽  
Jérémie Théreaux ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Esophagectomy For Cancer

scholarly journals MLTI-19. VENOUS THROMBOEMBOLIC EVENTS IN PATIENTS WITH BRAIN METASTASES: THE PICOS SCORE

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i18-i18
Author(s):  
Fabian Wolpert ◽  
Bettina Grossenbacher ◽  
Anna Lareida ◽  
Patrick Roth ◽  
Marian Neidert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Metastasis ◽  
Odds Ratio ◽  
Thromboembolic Event ◽  
Venous Thromboembolic Event ◽  
Thromboembolic Events ◽  
Primary Tumors ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Score Model

Abstract BACKGROUND: Venous thromboembolic events are significant complications in patients and possibly associated with an unfavorable outcome. Thrombosis risk is poorly defined for patients with brain metastasis, and available risk calculation scores are not validated for these patients. METHODS: We identified 811 patients with brain metastasis followed at our institution and screened electronic charts retrospectively for the occurrence of venous thromboembolic events, along with candidate risk factors. Risk factors were tested in uni- and multivariate analyses and finally integrated in a score model for risk prediction. RESULTS: Venous thromboembolic events were documented in 97 of 811 patients (12.0%). Primary tumors with high thrombogenicity (p=0.02, odds ratio 1.7, 95% CI 1.1–2.8), dexamethasone (p=0.011, odds ratio 2.27, 95% CI 1.5–4.5), chemotherapy (p=0.005, odds ratio 3.4, 95% CI 1.6–7.5), BMI &gt; 35 kg/m2 (p=0.002, odds ratio 3.4, 95% CI 1.6–7.5) and immobilization (p=0.003, odds ratio 2.4, 95% CI 1.3–4.3) were confirmed as independent predictors of VTE. We derived a score model for venous thromboembolic event prediction, the PICOS (thrombogenic Primary, Immobilization, Chemotherapy, Obesity, Steroids) score (0–7 points). Receiver Operating Characteristic Curve Analysis demonstrated its prognostic accuracy (AUC=0.71, 95% CI 0.64–0.77), and its predictive capability was superior to that of other scores proposed for the evaluation of venous thromboembolic event risk such as the Khorana (AUC=0.51) or CONKO (AUC=0.52) scores. CONCLUSIONS: We report a rate of venous thrombotic events of 12.0% in our cohort of 811 patients with brain metastasis. We define a risk model for prediction in of venous thrombotic events in patients with BM, the PICOS score. It may become a valuable tool for the identification of brain metastasis patients at high risk for venous thromboembolic events and be helpful for guidance of clinicians towards decision whether to start thrombosis prophylaxis. Further, the PICOS score might be used for stratification in controlled studies.

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