scholarly journals (P1-76) Descriptive Study of Poisoning Victims Patients at a Tertiary Medical Center in Northern Thailand

2011 ◽  
Vol 26 (S1) ◽  
pp. s123-s123 ◽  
Author(s):  
P.C. Inboriboon ◽  
P. Narongchai
Keyword(s):  
High Risk ◽  
Predictive Model ◽  
Demographic Data ◽  
Public Health Problem ◽  
University Hospital ◽  
Poison Control ◽  
Northern Thailand ◽  
Chemical Agents ◽  
Younger Age ◽  
Increased Risk

BackgroundPoisoning is a public health problem that effects all ages, genders, and ethnicities, but certain populations are at increased risk. Unintentional poisoning disproportionately affects lower- and middle-income countries. The epidemiological pattern of poisoning can differ significantly within countries. In Thailand, national poisoning data is collected by voluntary reporting to a poison control center in the capital, Bangkok. Limited poisonings are reported from Chiang Mai, a province in Northern Thailand, though it has the highest suicide rate in the country.ObjectiveThe aim of this study is to describe poisoning epidemiology, examine differences between intentional and unintentional poisonings and, to develop a multivariate predictive model of intentional poisonings in Northern Thailand.MethodsA total of 550 poisoning admissions were identified at Chiang Mai's University Hospital from 01 January 2005 to 31 December 2005. Demographic data were collected retrospectively by manual chart review. Chi-square and t-tests were used to examine differences in poisoning by intent. A step-wise logistic regression analysis was performed to develop a predictive model of intentional poisonings. Factors significantly associated with intentional poisoning were used in a logistic progression model to identify predictors of intentional poisoning.ResultsYounger age was significantly associated with intentional poisoning. There was no demonstrated difference in gender and poisoning intent. Predictors of intentional poisonings were use of chemical agents, high-risk medications (analgesics and psychiatric), unemployment, and younger age.ConclusionsInterventions should focus on factors that put young adults and the unemployed at greater risk for intentional poisonings. Further interventions are also needed to limit access to potentially lethal doses of chemical agents and high risk medications.

scholarly journals Quality of life and risk of feminicide in women victims of intimate partner violence in Campinas

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Caicedo Roa ◽  
L Gabrielle Dalaqua ◽  
P Filizola ◽  
R Cordeiro
Keyword(s):  
Quality Of Life ◽  
Domestic Violence ◽  
Intimate Partner Violence ◽  
High Risk ◽  
Women Victims ◽  
Partner Violence ◽  
Public Health Problem ◽  
Intimate Partner ◽  
Increased Risk

Abstract Introduction Violence against women is a public health problem with severe consequences. Most women in situations of domestic violence are emotionally involved and/or economically dependent of their intimate partners contributing to the perpetuation and acceptance of violence. Objectives 1) To characterize the women who join the Reference and Support Center for Women (Ceamo) in Campinas, Southeast Brazil. 2) To measure the quality of life in women victims of intimate partner violence 3) To determine the risk of feminicide. Methods The Ceamo is a public specialized service from the mayor of Campinas, it provides psychological, social and legal guidance to women in situations of gender violence. Inclusion criteria: Women attending Ceamo services, speaking Portuguese, age ≥18 years old and having experienced intimate partner violence. Measure instruments: Danger assessment Scale and WHOQOL-BREF. Results During the 11 months of the study, 78 new users were recruited. Average age 38.3 years old, mostly married/stable union, most of them with children (88%). 64% of women do not work and 36% live with the abusive partner. Prevalent types of violence suffered during by the victims in the last year were psychological n = 76, physical n = 62, moral n = 54 and sexual n = 23. The domain most affected in the assessment of quality of life was the environment (average 42% /100%) and psychological domain (42%/100%). 49% of women were classified with increased risk, 22% with severe risk and 1% with extreme risk of femicide. The questions with the most positive answers were those related to believing that the partner can kill her (77%), jealous of the partner (76%) and controlling behavior (73%), being followed/spied by the partner (67%) and threat death (65%). Conclusions The service in general receive very vulnerable women with low perception of their own quality of life, precarious material conditions and high risk of femicide. Key messages The women in domestic violence situation attended by the Ceamo service are at high risk of femicide. Service users have very low perception of their quality of life and poor social conditions.

scholarly journals High prevalence of SARS-CoV-2 infection among symptomatic healthcare workers in a large university tertiary hospital in São Paulo, Brazil

2020 ◽  
Author(s):  
Carolina Palamin Buonafine ◽  
Beatriz Nobre Monteiro Paiatto ◽  
Fabyano Leal ◽  
Samantha Matos ◽  
Camila Ohomoto Moraes ◽  
...  
Keyword(s):  
Latin America ◽  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Medical Condition ◽  
Demographic Data ◽  
Sao Paulo ◽  
University Hospital ◽  
São Paulo ◽  
Ocular Pain ◽  
Increased Risk

Abstract Background: Latin America became the epicenter of the COVID-19 pandemic in May 2020, mostly driven by Brazil's situation. Healthcare workers are at increased risk of SARS-CoV-2 infection, experiencing a significant burden from COVID-19. Identifying and understanding the clinical characteristics and risk factors associated with infection are of paramount importance to inform screening strategies and infection control practices in this scenario. The aims of this study were to investigate the prevalence and clinical characteristics of healthcare workers with COVID-19 symptoms. Methods: Between March 21 st and May 22 nd , 2020 a cross-sectional study was performed in a tertiary university hospital in São Paulo. Prevalence of SARS-CoV-2 infection among health care workers with COVID-19 symptoms was determined by RT-PCR testing on nasopharyngeal and oropharyngeal samples. Participants were asked to complete an electronic structured questionnaire including clinical and demographic data. Results: Overall, 125 (42.37%) of 295 symptomatic healthcare workers tested positive for SARS-CoV-2. Over the 10-week study period, positivity rates varied from 22.2% (CI 95% 15.9% - 60.3%) in the second week to 55.9% (CI 95% 43.2% - 68.6%) in the sixth week, reaching a plateau (38% - 46%) thereafter. Median (SD) age was 34.2 (9.9) years and 205 (69.5%) were female. We did not find significant differences in the prevalence of the most commonly reported underlying medical condition among healthcare workers that tested positive or negative for SARS-CoV-2 infection. After multivariate analysis, using logistic regression, anosmia (OR 4.4 95% C.I. 2.21 - 8.74) and ocular pain (OR 1.95 C.I. 95% 1.14 - 3.33) were the only symptoms independently associated with positivity for SARS-CoV-2 infection. Follow-up information on clinical outcomes showed that 9 (7.2%) healthcare workers were hospitalized (seven were male) and 2 (1.6%) died. Conclusions: The findings of this study confirmed the high burden of SARS-CoV-2 infection among healthcare workers in the hardest hit city by the pandemic in Latin America. Anosmia and ocular pain were symptoms independently associated with COVID-19 diagnosis. In low and middle-income countries, where limited availability of tests is frequent, these findings may contribute to optimize a targeted symptom-oriented screening strategy.

scholarly journals Triage and flow management in sepsis

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Hudson Henrique Gomes Pires ◽  
Fábio Fernandes Neves ◽  
Antonio Pazin-Filho
Keyword(s):  
Intensive Care ◽  
Demographic Data ◽  
Waiting Times ◽  
Public Health Problem ◽  
Interquartile Range ◽  
Critical Conditions ◽  
Major Public Health Problem ◽  
Surgical Interventions ◽  
Increased Risk ◽  
Incidence And Mortality

Abstract Background Sepsis is a major public health problem, with a growing incidence and mortality rates still close to 30% in severe cases. The speed and adequacy of the treatment administered in the first hours of sepsis, particularly access to intensive care, are important to reduce mortality. This study compared the triage strategies and intensive care rationing between septic patients and patients with other indications of intensive care. This study included all patients with signs for intensive care, enrolled in the intensive care management system of a Brazilian tertiary public emergency hospital, from January 1, 2010, to December 31, 2016. The intensivist periodically evaluated the requests, prioritizing them according to a semi-quantitative scale. Demographic data, Charlson Comorbidity Index (CCI), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA), as well as surgical interventions, were used as possible confounding factors in the construction of incremental logistic regression models for prioritization and admission to intensive care outcomes. Results The study analyzed 9195 ICU requests; septic patients accounted for 1076 cases (11.7%), 293 (27.2%) of which were regarded as priority 1. Priority 1 septic patients were more frequently hospitalized in the ICU than nonseptic patients (52.2% vs. 34.9%, p <  0.01). Septic patients waited longer for the vacancy, with a median delay time of 43.9 h (interquartile range 18.2–108.0), whereas nonseptic patients waited 32.5 h (interquartile range 11.5–75.8)—p <  0.01. Overall mortality was significantly higher in the septic group than in the group of patients with other indications for intensive care (72.3% vs. 39.8%, p <  0.01). This trend became more evident after the multivariate analysis, and the mortality odds ratio was almost three times higher in septic patients (2.7, 2.3–3.1). Conclusion Septic patients had a lower priority for ICU admission and longer waiting times for an ICU vacancy than patients with other critical conditions. Overall, this implied a 2.7-fold increased risk of mortality in septic patients.

Incidence of venous thromboembolic disease (VTE) in a cohort of patients with colorectal cancer (CRC) according to KRAS, NRAS and BRAF status.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15136-e15136
Author(s):  
Pilar Garcia-Alfonso ◽  
Laura Ortega Morán ◽  
Iria Gallego Gallego ◽  
Gonzalo García González ◽  
Gabriela Torres Pérez-Solero ◽  
...  
Keyword(s):  
High Risk ◽  
Predictive Model ◽  
Metastatic Disease ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Low Risk ◽  
Intermediate Risk ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Cancer Associated Thrombosis

e15136 Background: A recent study has suggested that KRAS mutation could increase the risk of VTE in patients with CRC. The role of others biomarkers, such as BRAF, in this setting is unknown. The aim of this study is to analyze the incidence of cancer-associated thrombosis in a cohort of patients with CRC based on KRAS, NRAS and BRAF status. Methods: We performed a retrospective review of patients with metastatic CRC and KRAS/NRAS/BRAF status known, attended in the Medical Oncology Department of the Hospital General Universitario Gregorio Marañón (Madrid, Spain) between January 2010 and January 2018. Results: 194 patients were identified and included in the analysis. The median age was 64 years (18-86). Most were metastatic at diagnosis (58.1%). Khorana’s predictive model: low-risk 67.7%, intermediate-risk 31.0%, high-risk 2.3%. The median follow-up was 35 months (2-240). 41 patients (21.1%) experienced VTE (11 pulmonary embolism, 15 lower extremity deep-vein thrombosis, 12 visceral vein thrombosis, 2 catheter-related thrombosis, 1 unknown). Most had metastatic disease at the moment of VTE (90.2%). 40% of the events occurred at the time of diagnosis or within the first 6 months. 65% were incidental events. Khorana’s predictive model in VTE patients: low-risk 63.4%, intermediate-risk 24.5%, high-risk 7.3%. According to biomarkers, the incidence was 19.1% (13/68) in KRAS/NRAS mutated patients, 28.6% (6/21) in BRAF mutated patients and 21% (22/105) in triple-wild-type patients. 6/38 patients (15.8%) developed recurrent thrombosis. In the univariate analysis, the presence of chronic kidney disease (p = 0.022), ECOG ≥ 2 (p = 0.038) and high-risk Khorana score (p = 0.011) were significantly associated with increased risk of VTE. Metastatic disease showed a trend towards the statistical significance (p = 0.053). In the multivariate model, including this variables, age, sex and biomarkers, only ECOG ≥ 2 remained independent predictor of VTE (OR 8.73; CI 95% 1.32-57.82; p = 0.025). Conclusions: The biomarkers have not been associated with the risk of VTE. We have observed a high incidence of VTE in BRAF mutated patients that should be investigated in further studies.

Validation of a Predictive Model for Indentifying An Increased Risk for Thromboembolism in Children with Acute Lymphoblastic Leukemia: Results of a Multicenter Cohort Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 524-524
Author(s):  
Silke Flege ◽  
Lesley Mitchell ◽  
Gili Kenet ◽  
Christine Heller ◽  
Michael Fruhwald ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Predictive Model ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
Low Risk ◽  
Carrier Status ◽  
Central Venous ◽  
Increased Risk ◽  
Genetic Abnormalities

Abstract Children with acute lymphoblastic leukemia (ALL) are at increased risk for venous thromboembolism (VTE), however, not all children experience a VTE. Developing a predictive model for determining children at increased risk would be beneficial in targeting interventional studies to only high risk groups. A recent meta-analysis of studies in VTE in children with ALL identified four potential risk factors: treatment with Escherichia coli asparaginase (CASP), concomitant use of steroids, presence of central venous lines and thrombophilic genetic abnormalities. As VTE in childhood ALL is well recognized as serious clinical problem and due to the lack of studies on prevention, the standard of practice varies and some centres use enoxaparin prophylaxis for these children. However, the risks and benefits of the intervention are unknown. The aim of the study was to develop a simple model for predicting ALL-chemotherapy-associated VTE using baseline clinical and laboratory variables, and to evaluate, on an explorative basis, the increasing off-label use of enoxaparin for VTE prophylaxis in ALL children. For development of the risk model the predictive variables were scored as follows: treatment with CASP (5000–10000/m2) in combination with prednisone or dexamethasone, presence of central venous lines, thrombophilic genetic abnormalities, e.g. positive family history for VTE or identification of a single thrombophilic trait (1 point each), or carrier status of combined thrombophilic traits (2 points). A definition of VTE risk by score was low (1–2) and high (□ 3). The risk score was than prospectively validated in an independent cohort of 136 newly recruited patients enrolled into the German database. Seven patients were excluded (lost to follow-up n=2; death n=2, secondary malignancy, VTE before ALL-onset, infant &lt; 12 months of age: each n=1). The cumulative VTE rates at 3.5 months in the validation cohorts were 3.6% (95% CI 1%–9%) in the low-risk group (4 of 112), and 47% (95%CI 23%–72%) in the high-risk category (8 of 17). In multivariate analysis [Cox regression] the high risk group was significantly associated with VTE when compared to the low risk group even after adjusting for age at ALL-onset, duration of CASP administration, steroid administered (prednisone/dexamethasone), and presence or absence of enoxaparin prophylaxis [hazard/95%CI: 4.16/1.13–15.34]. The negative predictive value for VTE was 96.3% [95%CI: 92.9–99.8]. Early enoxaparin prophylaxis reduced the absolute VTE-risk about 60% [95%CI: 23–96]. Therefore, the model can identify ALL-children with an increased risk for symptomatic VTE.

scholarly journals Acute Pulmonary Embolism at Tanta University Hospital: Single Centre Registry

2021 ◽  
pp. 23-32
Author(s):  
Alaa Raafat Elesawi Elkhateeb ◽  
Ahmed Farouk Alarag ◽  
Taymoor Mostafa Abdallah ◽  
Seham Fahmy Badr
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Acute Pulmonary Embolism ◽  
Previous History ◽  
Real Life ◽  
University Hospital ◽  
Treatment Modalities ◽  
Increased Risk ◽  
Active Cancer

Background: Pulmonary embolism (PE) is a major cause of morbidity and mortality worldwide, and has significant negative impacts on quality of life, healthcare costs, and longevity. Registries have been created to record ‘real-life’ clinical features and management of patients with PE. Aim: We aimed to describe a comprehensive view of the clinical presentation, demographic data, treatment modalities and short-term outcome at hospital discharge and 3 months after discharge for patients presented with acute pulmonary embolism at Tanta university hospital to improve the level of care of those patients. Methods: This study was conducted on 150 patients with confirmed acute PE presented to Tanta university hospitals. The study duration was 1 year from April 2019 to May 2020. Results: We focused on a group of common risk factors for PE and determined prevelance of each in our enrolled patients, we found increase some risk factors obesity and bed rest > 3 days were the most prevalent risk factors followed by active cancer, estrogen use and lower limb fracture. Symptoms in this study are near to other registries and ESC guidelines 2019 with the commonest symptom was dyspnea and chest pain and the least symptom was hemoptysis. Certain ECG signs more prevalent in our patients and these signs related to RV strain with sinus tachycardia the commonest sign followed by S1Q3T3 sign and the least was right axis deviation. Conclusion: Presence of active cancer and patients with high risk stratification were independent predictors of mortality. Other factors associated with increased mortality were impaired RV systolic function, high PESI score, presence of RBBB in ECG and presence of congestive heart failure. Increased risk of bleeding in male patients with intermediate high or high risk category especially those received UFH and fibrinolytic therapy. Previous history of VTE was independent predictors of VTE recurrence.

scholarly journals The Prevalence of High Risk of Obstructive Sleep Apnea and its Association with Sociodemographic Factors among Adults in Taman Dato' Rashid Salleh, Indera Mahkota, Kuantan

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Rawahah Husna Ramli ◽  
Artika Hassan ◽  
Jamalludin Abd Rahman ◽  
Razman Mohd Rus ◽  
Hafizah Pasi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Demographic Data ◽  
Adult Population ◽  
Neck Circumference ◽  
P Value ◽  
Berlin Questionnaire ◽  
Obstructive Sleep ◽  
Increased Risk

Introduction: Obstructive sleep apnea (OSA) is an insidious sleep breathing disorder, with cardinal manifestations of snoring, witnessed breathing pause during sleep and excessive daytime sleepiness. The aim of the study was to estimate the prevalence of OSA and its associated factors among adult population in Taman Dato’ Rashid Salleh, Kuantan. Materials and  method: A cross-sectional study was carried out among 157 participants who lived in Taman Dato’ Rashid Salleh from May 2018 to June 2018. Obstructive sleep apnea was quantified using the self-administered Malaynvalidated Berlin questionnaire which apart from the demographic data included three categories (10 questions) designed to elicit information regarding snoring (category 1), daytime somnolence (category 2) and the presence of obesity and/or hypertension (category 3). The respondents were considered as high risk of OSA if two or more categories were positive. Weight, height and neck circumference were measured by using Secca© weight scales, Secca© stadiometer and non-elastic plastic tape, respectively. Descriptive statistics was used to measure the prevalence, while chi-square test was used to explore the association of OSA and its background variables. Results: Out of 157 respondents, female and Malay were dominant with the 56.7% and 91.0 %, respectively. The mean age of the respondents was 36.7 (12.2) years old. The prevalence of high risk of OSA in was 18.5%. There was no association between gender, age, race, smoking and neck circumference with risk of OSA while Body Mass Index (BMI) and hypertension were significantly related to an increased risk for developing OSA (p-value < 0.001 and p=0.001, respectively).  Conclusions: Two in every 10 adults in Taman Dato’ Rashid Salleh, Kuantan were at high risk of OSA. It is recommended that appropriate health promotion should be targeted to this community to instill awareness and increase the level of understanding of the public on OSA.

scholarly journals Impact of social contacts on SARS-CoV-2 exposure among healthcare workers

2021 ◽  
Author(s):  
A N Emecen ◽  
S Keskin ◽  
E Boncukcu Eren ◽  
B Yildirim Ustuner ◽  
S G Celik ◽  
...  
Keyword(s):  
High Risk ◽  
Patient Care ◽  
Healthcare Workers ◽  
Conditional Logistic Regression ◽  
University Hospital ◽  
Contact Tracing ◽  
Risk Exposure ◽  
Social Contacts ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background Healthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure. Aims This study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm. Methods Contact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers. Results Of the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P &lt; 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P &lt; 0.001), in non-patient care settings (47%, P &lt; 0.001) and in the social contacts (57%, P &lt; 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62–4.69) in multivariate analysis. Conclusions A significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.

scholarly journals Assessment of Teachers’ Knowledge about Tuberculosis at Primary School in Balad City

2020 ◽  
Vol 1591 (1) ◽  
pp. 012001
Author(s):  
Wafaa S. Hasanain
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Primary Schools ◽  
Demographic Data ◽  
Statistical Treatment ◽  
Public Health Problem ◽  
World Health ◽  
Bacterial Disease ◽  
Major Public Health Problem ◽  
Diagnostic Features ◽  
Increased Risk

Abstract Tuberculosis (TB) is one of the most common infectious diseases worldwide and continues to be a major public health problem for low and middle-income countries. Undoubtedly, Lack of knowledge about tuberculosis among health care and education workers, as well as if knowledge and practices of tuberculosis among students were generally insufficient causes an increased risk of contracting the disease. Tuberculosis (TB) is a chronic communicable bacterial disease caused by Mycobacterium tuberculosis. The Latest World Health Organization (WHO) Report shows that there were 9.0 Million new TB cases and 1.5 Million tuberculosis deaths. The Transmission of the TB disease by Mycobacterium tuberculosis (a bacterium of a group that includes the causative agents of tuberculosis). takes place by air in the form of sneeze, talk, cough, spit, etc. [1,9,11,12,13] This applied study attempt to identify, assess and analyze teachers’ knowledge about tuberculosis in primary schools. A descriptive design, cross-sectional study was carried out in order to achieve the earlier stated objectives of this study by find out the relationship between teachers’ knowledge and social demographic data (sex, age, academic achievement, ….). The present study lasted for four months by prepared a questionnaires to assess the level of teachers’ knowledge, and these questionnaire contains many themes, each theme contained a number of questions to evaluate and analyze teachers’ knowledge of tuberculosis by answering a set of questions (as a variables); (mode of transmission, symptoms and signs, diagnostic features of TB, duration of treatment, prevention methods, risk of developing tuberculosis). The research hypothesis also states that (mycobacterium tuberculosis factor) has a direct impact on TB infection, and to achieve this hypothesis, a questionnaire was distributed to a sample with a size of (58) teachers and the method of Multiple Logistic Regression was used for statistical treatment. Finally, the research concluded a set of results and conclusions included in tables by comparing Likelihood-ratio chi-square statistics and classification table of the observed versus predicted responses.

Venous thromboembolism (VTE) in patients with ALK-rearranged non-small cell lung cancer (ALK-LC): A population-based cohort.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6608-6608
Author(s):  
Alona Zer ◽  
Lilach Joseph ◽  
Erez Battat ◽  
Tzippy Shochat ◽  
Avi Leader ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Individual Patient Data ◽  
Smoking Status ◽  
Demographic Data ◽  
Population Based ◽  
Patient Data ◽  
Morbidity Score ◽  
Increased Risk ◽  
Co Morbidity

6608 Background: Advanced NSCLC is associated with an increased risk for VTE, with a reported rate of 8-15%. Clinical observations suggest a higher rate of VTE in patients with ALK-rearranged NSCLC. Clalit Health Services (CHS) is both a healthcare payer and provider, covering over 50% of the population in Israel, with individual patient data recorded in a centralized electronic database. We aimed to determine the incidence of VTE in patients with ALK-LC using a population-based cohort. Methods: We identified all patients diagnosed with NSCLC between 01/2012-12/2017 within CHS. Clinical and demographic data (including VTE risk factors, i.e. components of the Khorana score) were extracted from the CHS registry for all patients. Patients with ALK-LC were identified according to crizotinib prescriptions (dispensed after an approved CHS' pre-authorization for an ALK-LC diagnosis). VTE was identified by ICD diagnosis codes 415.xx, 444.xx, 451.xx and 453.xx. VTE risk factors (Khorana score) were also extracted. Association between ALK-LC and VTE were analyzed using logistic regression, estimating univariate and multivariate Odds Ratios (OR). Results: Overall, 4327 patients with a diagnosis of NSCLC were identified. 149 (3%) had at least one prescription for crizotinib for advanced ALK-LC. The rate of VTE in these patients was 25% (38 of 149 patients), while in the non-ALK-LC the rate was 14% (596/4178), OR = 2.05, p = 0.0004. The association was significant also in a multivariate analysis adjusting for, age, smoking status, BMI, platelet count, hemoglobin and Charlson co-morbidity score (OR 1.66, p = 0.018). Conclusions: This pooled analysis of individual patient data confirms prior data from smaller retrospective studies, suggesting ALK-LC is associated with a high risk of VTE. Randomized trials with prophylactic anti-coagulation are unlikely to be performed in this rare subtype, thus increased awareness and consideration of VTE prophylaxis in high risk patients is warranted.

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