Predictors of venous thromboembolism recurrence and bleeding among active cancer patients: a population-based cohort study

Key Points VTE recurrence risk in patients with cancer can be stratified by cancer type, stage, stage progression, and presence of leg paresis. Patients with cancer at high VTE recurrence risk should be considered for secondary prophylaxis.

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Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

Thrombosis and Haemostasis ◽

10.1160/th13-09-0793 ◽

2014 ◽

Vol 112 (08) ◽

pp. 255-263 ◽

Cited By ~ 80

Author(s):

Alexander T. Cohen ◽

Luke Bamber ◽

Stephan Rietbrock ◽

Carlos Martinez

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

The Elderly ◽

Population Based ◽

Incidence Rates ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Recurrence Rates ◽

Recurrent Vte ◽

Active Cancer

SummaryContemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2–132.9) per 100,000 person-years and 107.0 (95% CI, 105.8–108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4–10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

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Predictors of Venous Thromboembolism Recurrence, Adjusted for Treatments and Interim Exposures: A Population-based Case-cohort Study

Thrombosis Research ◽

10.1016/j.thromres.2015.06.030 ◽

2015 ◽

Vol 136 (2) ◽

pp. 298-307 ◽

Cited By ~ 21

Author(s):

John A. Heit ◽

Brian D. Lahr ◽

Aneel A. Ashrani ◽

Tanya M. Petterson ◽

Kent R. Bailey

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

Population Based ◽

Venous Thromboembolism Recurrence

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Impact of risk factors on the timing of first postpartum venous thromboembolism: a population-based cohort study from England

Blood ◽

10.1182/blood-2014-05-572834 ◽

2014 ◽

Vol 124 (18) ◽

pp. 2872-2880 ◽

Cited By ~ 36

Author(s):

Alyshah Abdul Sultan ◽

Matthew J. Grainge ◽

Joe West ◽

Kate M. Fleming ◽

Catherine Nelson-Piercy ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Preterm Birth ◽

Venous Thromboembolism ◽

Cesarean Delivery ◽

Postpartum Hemorrhage ◽

Relative Rate ◽

Population Based ◽

Key Points

Key Points For women with preeclampsia, BMI >30 kg/m2, infection, or those having cesarean delivery, VTE risk remained elevated for 6 weeks postpartum. For women with postpartum hemorrhage or preterm birth, the relative rate of VTE was only increased for the first 3 weeks postpartum.

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Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom

Blood ◽

10.1182/blood-2012-11-469551 ◽

2013 ◽

Vol 121 (19) ◽

pp. 3953-3961 ◽

Cited By ~ 108

Author(s):

Alyshah Abdul Sultan ◽

Laila J. Tata ◽

Joe West ◽

Linda Fiaschi ◽

Kate M. Fleming ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

United Kingdom ◽

Preterm Birth ◽

Venous Thromboembolism ◽

Population Based ◽

The United Kingdom ◽

Key Points ◽

Modest Effect

Key Points Antepartum, we found that established risk factors only had a modest effect on rates of VTE. Postpartum, we found that among other factors, women with stillbirth or preterm birth had high rates of VTE.

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Risk of infections and mortality in Danish patients with cancer diagnosed with bone metastases: a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049831 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049831

Author(s):

Thomas Johannesson Hjelholt ◽

Thomas Bøjer Rasmussen ◽

Anouchka Seesaghur ◽

Rohini K Hernandez ◽

Andrea Marongiu ◽

...

Keyword(s):

Cohort Study ◽

Urinary Tract ◽

Bone Metastases ◽

Urinary Tract Infections ◽

Population Based ◽

Cancer Type ◽

Patients With Cancer ◽

Severe Infections ◽

Tract Infections

ObjectivesRisk of infections in patients with solid cancers and bone metastases (BM) and the subsequent impact on prognosis is unclear. We examined the risk of infections among patients with cancer diagnosed with BM and the subsequent impact of infections on mortality.DesignPopulation-based cohort study.SettingDanish medical databases holding information on all hospital contacts in Denmark.ParticipantsAdult patients with solid cancers and BM between 1 January 1994 and 30 November 2013.Outcome measuresIn the risk analyses, the outcome was time to hospitalisation for common severe infections, pneumonia, sepsis and urinary tract infections. In the mortality analysis, we used Cox regression to compute HRs of death, modelling infection as time-varying exposure, stratifying for primary cancer type and adjusting for age, sex and comorbidities.ResultsAmong 23 336 patients with cancer and BM, cumulative incidences of common severe infections were 4.6%, 14.0% and 20.0% during 1 month, 1 year and 10 years follow-up. The highest incidence was observed for pneumonia, followed by urinary tract infections and sepsis. Infection was a strong predictor of 1 month mortality (adjusted HR: 2.1 (95% CI 1.8 to 2.3)) and HRs increased after 1 and 10 years: 2.4 (95% CI 2.3 to 2.6) and 2.4 (95% CI 2.4 to 2.6). Sepsis and pneumonia were the strongest predictors of death. Results were consistent across cancer types.ConclusionPatients with cancer and BM were at high risk of infections, which was associated with a more than twofold increased risk of death for up to 10 years of follow-up. The findings underscore the importance of preventing infections in patients with cancer and BM.

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