scholarly journals Von Willebrand Factor:Antigen And Adamts-13 Level, But Not Soluble P-Selectin, Are Risk Factors For The First Asymptomatic Deep Vein Thrombosis In Cancer Patients Undergoing Chemotherapy

2020 ◽  
Author(s):  
Budi Setiawan ◽  
Cecilia Oktaria Permatadewi ◽  
Baringin de Samakto ◽  
Ashar Bugis ◽  
Ridho M. Naibaho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Logistic Regression Model ◽  
Everyday Clinical Practice ◽  
Vein Thrombosis ◽  
Patients With Cancer ◽  
Chemotherapy Induction ◽  
Von Willebrand ◽  
Deep Vein

Abstract METHODS: We measured sP-selectin, vWF:Ag and ADAMTS-13 levels at baseline RESULTS: Forty patients with cancer were included in the study, all were recuited before their first chemotherapy induction. vWF:Ag and ADAMTS-13 were significantly associated with cancer chemotherapy accounting to increased RR for first asymptomatic DVT in the logistic regression model.CONCLUSIONS: Further research is needed to determine whether incorporating vWF:Ag and ADAMTS-13 levels wil find use in everyday clinical practice. Once validated, these results may specify particular cancer patients to be treated with prophylactic anticoagulant.

scholarly journals Von Willebrand Factor:Antigen And Adamts-13 Level, But Not Soluble P-Selectin, Are Risk Factors For The First Asymptomatic Deep Vein Thrombosis In Cancer Patients Undergoing Chemotherapy

2020 ◽  
Author(s):  
Budi Setiawan ◽  
Cecilia Oktaria Permatadewi ◽  
Baringin de Samakto ◽  
Ashar Bugis ◽  
Ridho M. Naibaho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Plasma Levels ◽  
Blood Type ◽  
Vein Thrombosis ◽  
Soluble P ◽  
Von Willebrand ◽  
Deep Vein

Abstract BackgroundThere is a high incidence of deep vein thrombosis (DVT) among cancer patients undergoing chemotherapy. Chemotherapy-induced vascular endothelial cell activation (VECA) is characterized by increased plasma levels of von Willebrand factor (vWF) and soluble P-selectin (sP-selectin), leading to the activation of endothelial cells and signaling cascades. The biological role of a disintegrin-like and metalloproteinase with thrombospondin type 1 motif, member 13 (ADAMTS-13) is to control the activity of vWF and consequently the risk of thrombosis. The objective of this study was to investigate the roles of sP-selectin, vWF, and ADAMTS-13 as risk factors for the first episode of DVT in cancer patients undergoing chemotherapy.MethodsThis prospective cohort study was conducted at Dr. Kariadi Hospital, Indonesia, on 40 cancer patients. Prechemotherapy (baseline) and postchemotherapy sP-selectin, vWF antigen (vWF:Ag), and ADAMTS-13 plasma levels were determined with ELISAs before and 3 months after chemotherapy. The clinical characteristics of the patients, cancer type, cancer stage, chemotherapy regimen, ABO blood type, D-dimer level and Khorana risk score were also analyzed using logistic regression. Patients were observed for the possibility of developing DVT during chemotherapy.ResultsDVT was confirmed in 5 patients (12.5%) after a period of 3 months. In patients with DVT, sP-selectin and vWF were significantly higher while ADAMTS-13 was lower than in their counterparts. The levels of baseline vWF:Ag and ADAMTS-13, with cut-off points ≥ 2.35 IU/mL and ≤ 1.03 IU/mL, respectively, were found to independently predict the incidence of DVT. In the multivariate logistic regression analysis, the relative risk (RR) for DVT in patients with high vWF:Ag was 3.80 (95% CI 1.15-12.48, p=0.028), and that for patients with low ADAMTS-13 was 2.67 (95% CI 1.22-23.82, p=0.005). The vWF:Ag/ADAMTS-13 ratio and both vWF:Ag and ADAMTS-13 dynamics during treatment were also able to differentiate those with prospective DVT. However, sP-selectin and other covariates showed no statistical significance. ConclusionPrechemotherapy plasma levels of vWF:Ag ≥ 2.35 IU/mL and ADAMTS-13 ≤ 1.03 IU/mL are independent risk factors for DVT incidence.

scholarly journals Von Willebrand factor:antigen and ADAMTS-13 level, but not soluble P-selectin, are risk factors for the first asymptomatic deep vein thrombosis in cancer patients undergoing chemotherapy

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Budi Setiawan ◽  
Cecilia Oktaria Permatadewi ◽  
Baringin de Samakto ◽  
Ashar Bugis ◽  
Ridho M. Naibaho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Plasma Levels ◽  
Blood Type ◽  
Vein Thrombosis ◽  
Soluble P ◽  
Von Willebrand ◽  
Deep Vein

Abstract Background There is a high incidence of deep vein thrombosis (DVT) among cancer patients undergoing chemotherapy. Chemotherapy-induced vascular endothelial cell activation (VECA) is characterized by increased plasma levels of von Willebrand factor (vWF) and soluble P-selectin (sP-selectin), leading to the activation of endothelial cells and signaling cascades. The biological role of a disintegrin-like and metalloproteinase with thrombospondin type 1 motif, member 13 (ADAMTS-13) is to control the activity of vWF and consequently the risk of thrombosis. The objective of this study was to investigate the roles of sP-selectin, vWF, and ADAMTS-13 as risk factors for the first episode of DVT in cancer patients undergoing chemotherapy. Methods This prospective cohort study was conducted at Dr. Kariadi Hospital, Indonesia, on 40 cancer patients. Prechemotherapy (baseline) and postchemotherapy sP-selectin, vWF antigen (vWF:Ag), and ADAMTS-13 plasma levels were determined with ELISAs before and 3 months after chemotherapy. The clinical characteristics of the patients, cancer type, cancer stage, chemotherapy regimen, ABO blood type, D-dimer level and Khorana risk score were also analyzed using logistic regression. Patients were observed for the possibility of developing DVT during chemotherapy. Results DVT was confirmed in 5 patients (12.5%) after a period of 3 months. In patients with DVT, sP-selectin and vWF were significantly higher while ADAMTS-13 was lower than in their counterparts. The levels of baseline vWF:Ag and ADAMTS-13, with cut-off points ≥ 2.35 IU/mL and ≤ 1.03 IU/mL, respectively, were found to independently predict the incidence of DVT. In the multivariate logistic regression analysis, the relative risk (RR) for DVT in patients with high vWF:Ag was 3.80 (95% CI 1.15–12.48, p = 0.028), and that for patients with low ADAMTS-13 was 2.67 (95% CI 1.22–23.82, p = 0.005). The vWF:Ag/ADAMTS-13 ratio and both vWF:Ag and ADAMTS-13 dynamics during treatment were also able to differentiate those with prospective DVT. However, sP-selectin and other covariates showed no statistical significance. Conclusion We found that prechemotherapy plasma levels of vWF:Ag ≥ 2.35 IU/mL and ADAMTS-13 ≤ 1.03 IU/mL are independent risk factors for DVT incidence among cancer patients.

scholarly journals Von Willebrand Factor: Antigen and Adamts-13 Level, but not Soluble P-Selectin, are Risk Factors for the First Asymptomatic Deep Vein Thrombosis in Cancer Patients Undergoing Chemotherapy

2020 ◽  
Author(s):  
Budi Setiawan ◽  
Cecilia Oktaria Permatadewi ◽  
Baringin de Samakto ◽  
Ashar Bugis ◽  
Ridho M. Naibaho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Von Willebrand Factor ◽  
Plasma Levels ◽  
Vein Thrombosis ◽  
Von Willebrand ◽  
Deep Vein ◽  
Willebrand Factor

Abstract Background There is a high incidence of deep vein thrombosis (DVT) among cancer patients undergoing chemotherapy. Chemotherapy-induced vascular endothelial cell activation (VECA) is characterized by increased plasma levels of von Willebrand factor (vWF) and soluble P-selectin (sP-selectin), leading to the activation of endothelial cells and signaling cascades. The biological role of a disintegrin-like and metalloproteinase with thrombospondin type 1 motif, member 13 (ADAMTS-13) is to control the activity of vWF and consequently the risk of thrombosis. The objective of this study was to investigate the roles of sP-selectin, vWF, and ADAMTS-13 as risk factors for the first episode of DVT in cancer patients undergoing chemotherapy.Methods This prospective cohort study was conducted at Dr. Kariadi Hospital, Indonesia, on 40 cancer patients. Prechemotherapy (baseline) and postchemotherapy sP-selectin, vWF antigen (vWF:Ag), and ADAMTS-13 plasma levels were determined with ELISAs before and 3 months after chemotherapy. The clinical characteristics of the patients, cancer type, cancer stage, chemotherapy regimen, ABO blood type, D-dimer level and Khorana risk score were also analyzed using logistic regression. Patients were observed for the possibility of developing DVT during chemotherapy.Results DVT was confirmed in 5 patients (12.5%) after a period of 3 months. In patients with DVT, sP-selectin and vWF were significantly higher while ADAMTS-13 was lower than in their counterparts. The levels of baseline vWF:Ag and ADAMTS-13, with cut-off points ≥ 2.35 IU/mL and ≤ 1.03 IU/mL, respectively, were found to independently predict the incidence of DVT. In the multivariate logistic regression analysis, the relative risk (RR) for DVT in patients with high vWF:Ag was 3.80 (95% CI 1.15-12.48, p=0.028), and that for patients with low ADAMTS-13 was 2.67 (95% CI 1.22-23.82, p=0.005). The vWF:Ag/ADAMTS-13 ratio and both vWF:Ag and ADAMTS-13 dynamics during treatment were also able to differentiate those with prospective DVT. However, sP-selectin and other covariates showed no statistical significance.Conclusion We found that prechemotherapy plasma levels of vWF:Ag ≥ 2.35 IU/mL and ADAMTS-13 ≤ 1.03 IU/mL are independent risk factors for DVT incidence among cancer patients.

scholarly journals Soluble P-Selectin, Von Willebrand Factor, And Adamts13 Levels As Risk Factors Of Deep Vein Thrombosis In Cancer Patients Undergoing Chemotherapy

2020 ◽  
Author(s):  
Budi Setiawan ◽  
Cecilia Oktaria Permatadewi ◽  
Baringin de Samakto ◽  
Ashar Bugis ◽  
Eko Adhi Pangarsa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Plasma Levels ◽  
Vein Thrombosis ◽  
Soluble P ◽  
Von Willebrand ◽  
Deep Vein ◽  
Willebrand Factor

Abstract Background There is a high number of deep vein thrombosis (DVT) incidence among cancer patients undergoing chemotherapy. Chemotherapy-induced vascular endothelial cell activation (VECA) is marked with increasing plasma levels of von Willebrand Factor (VWF) and soluble P-selectin (sP-selectin) leading to activation of endothelial cells and coagulation cascade. The biological role of a disintegrin-like and metalloproteinase with thrombospondin type 1, motif 13 (ADAMTS13) is to control the activity of VWF. The objectives of this study is to investigate the role of sP-selectin, VWF, and ADAMTS13 as risk factors for the incidence of DVT in cancer patients undergoing chemotherapy. Methods This prospective cohort study was conducted in Dr. Kariadi hospital, Semarang Indonesia, on 40 cancer patients. Soluble P-selectin, VWF, and ADAMS13 plasma levels were determined with enzyme-linked immunosorbent assay (ELISA) method, examined before and after chemotherapy. These patients were observed for the possibility of developing DVT during three months. Results Deep vein thrombosis was confirmed in 5 patients (12.5%) after a median period of 8 weeks. In patients with DVT, sP-selectin and VWF were significantly higher, while ADAMTS13 were significantly lower compared in cancer patients without DVT. Pre- and post-chemotherapy concentration of sP selectin, VWF, and ADAMTS13 could effectively predict the incidence of DVT in cancer patients undergoing chemotherapy. The levels of sP-selectin, VWF and ADAMTS13 pre-chemotherapy with cut-off point >106.7 ng/mL, >2.99 U/mL and <0,80 U/mL, respectively, had relative risk (RR) for DVT incidence being 16 (95% CI 2,06-124,25, p=0,001); 36 (95% CI 5,21-248,65, p=0,000) and 10,5 (95% CI 1,31-84,28, p=0,015), respectively, whereas the levels of sP-selectin, VWF and ADAMTS13 post-chemotherapy with cut-off point >111.7 ng/mL, >3,06 U/mL and <0,49 U/mL, respectively, had RR for DVT incidence being 8.7 (95% CI 1,01-74,39, p=0,045); 20,4 (95% CI 2,60-159,94, p=0,004) and 26,25 (95% CI 3,50-196,48, p=0,002), respectively. Pre-chemotherapy vWF levels (cut-off value >2.99 U/mL) was found to be independently predict DVT incidence with RR 11.1 (95% CI, 1.95-62.74, p=0.007). Conclusions Plasma levels of VWF more than 2.99 U/mL pre-chemotherapy was an independent risk factor for DVT incidence, which could be performed early and helpful for thromboprophylaxis therapy.

Residual Vein Obstruction (RVO) Predicts Recurrence for Cancer Patients with Secondary VTE: A Meta-Analysis.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2259-2259
Author(s):  
Murali Janakiram ◽  
Matt R Sullivan ◽  
Marina Shcherba ◽  
Shuang Guo ◽  
Henny Heisler Billett
Keyword(s):  
Clinical Trials ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Vein Thrombosis ◽  
Patients With Cancer ◽  
Recurrent Vte ◽  
Deep Vein ◽  
Residual Vein Obstruction

Abstract Abstract 2259 Background: Venous thrombosis is a common disease and long term anticoagulation is effective in the prevention of venous thromboembolism (VTE). Studies to detect residual vein obstruction (RVO) performed at the end of the anticoagulation period has been investigated as a predictive marker for recurrent thrombotic risk. The value of this test has been questioned, and different methodologies, different patient populations, and varying lengths of prior anticoagulation may be responsible for the disparate results published. In order to assess the true predictive worth of RVO we performed a meta-analysis of published studies to determine whether RVO can predict the risk of recurrent VTE. Methods: A comprehensive literature search with the terms “deep vein thrombosis”, “residual vein thrombosis“, and “recurrent venous thromboembolism” was performed on PubMed, MEDLINE, EMBASE, Web of Science, the Cochrane dataset, Science Direct and CINAHL. Clinical trials published in English between January 1990 and December 2011 were eligible for this analysis. The selection of abstracts was based on the following criteria: studies had to be prospective, VTE patients had to have been anticoagulated with unfractionated heparin, low molecular weight heparin or warfarin for at least 6 weeks, and the presence of RVO and recurrent thromboembolic events had to have been recorded. The diagnosis of RVO was allowed if 1) a venous thrombosis of >2mm was present 2) the thrombus occupied >40% of vein diameter or 3) the presence of positive thrombosis on duplex was noted. Recurrent events were defined if a new contralateral deep vein thrombosis (DVT), a new ipsilateral DVT (if the prior DVT was documented to be recanalised) or a new PE (documented by perfusion scan, Computed Tomographic Angiography or pulmonary angiography) was noted. Data were analyzed with STATS Direct meta-analysis software. Analyses were performed for the whole VTE population as well as for unprovoked and provoked VTE cohorts. A sub-analysis of patients with cancer within the provoked cohort was performed. Odds Ratios (OR) with 95% confidence intervals were calculated for individual studies and Forrest plots were generated. Results: We identified 1955 potential publications, of which 28 were relevant. Thirteen studies met inclusion criteria and were included in the final analysis. 4546 patients, mean age 61years, with 3476 events were included. Five studies were prospective studies which recruited patients with only primary VTE, four studies examined secondary VTE only and four studies investigated both primary and secondary VTE. For all patients with VTE, primary and secondary, the presence of RVO was associated with a significantly higher recurrent VTE risk (OR 1.93. 95%CI: 1.29 –2.89, p = 0.001). When analyzed separately for primary VTE, RVO did not demonstrate a statistically significant increased recurrent VTE risk (OR 1.38, 95%CI: 0.87 – 2.08), results consistent with prior observations. When results were analyzed for patients with secondary VTE, the OR was 2.78 (95% CI: 1.4 – 5.5, p= 0.003). However, when patients with cancer were eliminated from the secondary VTE cohort, the OR decreased to 1.73 and was no longer significant (95% CI: 0.82 – 3.66). In contrast, for the two studies with cancer patients, the odds ratio for recurrent VTE given a positive RVO study was 5.14 (95% CI: 1.59 – 16.65 p = 0.006). While RVO studies showed recanalization and/or normalization after 6 months in 93% of post-operative patients, recanalization occurred in only 53% of patients who were treated for cancer, only 20% of patients with active cancer had negative RVO studies. Conclusions: A meta-analysis of 13 studies examining the predictive value of RVO studies did not detect significant utility for patients with primary VTE. RVO predicted recurrence in secondary VTE but subset analysis demonstrated that RVO seems to have predictive value primarily in the subgroup of patients with cancer. Current ACCP and NCCN guidelines for thrombosis in cancer differ in their recommemdation for duration of anticoagulation but both recommend extended anticoagulant therapy. A negative RVO study might reliably predict a group which might not need extended anticoagulation. Further prospective clinical trials are needed determining the utility of RVO in cancer patients with VTE. Disclosures: No relevant conflicts of interest to declare.

Risk factors for upper limb deep vein thrombosis associated with the use of central vein catheter in cancer patients

2008 ◽  
Vol 3 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Melina Verso ◽  
Giancarlo Agnelli ◽  
Pieter W. Kamphuisen ◽  
Walter Ageno ◽  
Mario Bazzan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Upper Limb ◽  
Central Vein ◽  
Vein Thrombosis ◽  
Vein Catheter ◽  
Central Vein Catheter ◽  
Deep Vein ◽  
Limb Deep Vein Thrombosis

scholarly journals Risk Factor of Deep Vein Thrombosis in Gynecologic Cancer Patients at Rajavithi Hospital

2018 ◽  
Vol 3 (1) ◽  
pp. 5
Author(s):  
Nawapas Pookcharoen ◽  
Putsarat Insin ◽  
Suvanna Asavapiriyanon
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Advanced Stage ◽  
Operative Blood Loss ◽  
Vein Thrombosis ◽  
Advanced Stage Cancer ◽  
Deep Vein

Background: Venous thromboembolism (VTE), that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant complication after major pelvic surgery and potentially lethal disease in gynecologic cancer patients. However, its incidence and associated risk factors have not been well established.Objectives: To evaluate risk factors that may be associated with deep vein thrombosis (DVT) in gynecologic cancer patients.Materials and Methods: This retrospective case-control study included patients who diagnosed as gynecologic cancer with or without DVT between January 2002 and December 2016 at Rajavithi Hospital. The presence of DVT was confirmed by either color doppler ultrasonography or computed tomography scan. Patient's demographic data, type and stage of cancer, including treatment modalities were compared. Univariate analysis and multivariate logistic regression analysis were analyzed to calculate odds ratios (OR) and determine independent risk factors for DVT.Results: Over 14 years periods, 242 patients with DVT were identified in a total 8476 gynecologic cancer patients. The incidence of DVT was 2.85% in this patient setting. Complete data were available in 468 patients, 156 (33.3%) cases with DVT diagnosed were compared with 312 (66.7%) controls without DVT. Among patients with DVT, the median time to DVT diagnosis was 4 months (IQR 2-12 months) after diagnosis of cancer, most of cases (89.5%) were symptomatic DVT, and a half of them (49%) were detected in ovarian cancer. In a multivariate analysis, 3 significant predictors of developing DVT were identified: advanced-stage cancer (OR 7.22; 95%CI 4.62-11.28, p<0.001), patient undergoing lymphadenectomy (OR 1.90; 95%CI 1.21-2.98, p=0.005), and patient with massive operative blood loss (≥1500 ml; OR 2.09; 95%CI 1.12-3.91, p=0.021).Conclusions: Awareness of DVT is the best way to prevent the venous thromboembolism. Therefore, an appropriate prophylaxis and closed monitoring of gynecologic cancer patients with advanced-stage cancer, undergoing lymphadenectomy, and massive operative blood loss should be mandatory to against thromboembolism complications.

Study on deep vein thrombosis (DVT) risk factors at the time of cancer diagnosis in patients from the multicenter, prospective Cancer-Venous Thromboembolism (VTE) Registry.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19323-e19323
Author(s):  
Yasuo Ohashi ◽  
Masataka Ikeda ◽  
Hideo Kunitoh ◽  
Mitsuru Sasako ◽  
Takuji Okusaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Hemoglobin Concentration ◽  
Multivariate Logistic Regression Model ◽  
Vein Thrombosis ◽  
Patients With Cancer ◽  
Asian Populations ◽  
Deep Vein ◽  
D Dimer

e19323 Background: Although the incidence of VTE is known to be high in cancer patients, many details of the frequency, risk factors, and management of VTE in patients with cancer remain unclear, especially in Asian populations. Methods: The multicenter, prospective, Cancer-VTE Registry study (UMIN000024942) aimed to clarify the actual status of VTE in cancer patients. The study enrolled patients diagnosed with colorectal, lung, stomach, breast, gynecological, or pancreatic cancer in Japan. Patients underwent VTE screening before initiating cancer treatment and were observed for 1 year. Registry objectives included the assessment of VTE prevalence and risk factors for VTE before initiating cancer treatment, real-world treatment of VTE, and frequency of new-onset events during the observation period. DVT screening was waived for those with a normal D-dimer level. Using a multivariate logistic regression model, we examined risk factors for DVT in cancer patients prior to initiating cancer treatment. Results: Of the 9726 patients enrolled, 3661 patients underwent DVT screening and 549 subjects were diagnosed with DVT. The risk factors for DVT among patients who underwent DVT screening (n=3661) are shown in the Table. Conclusions: The risk of DVT before initiating cancer treatment was clarified, and the factors strongly influencing DVT risk included age, sex, VTE history, D-dimer concentration, and hemoglobin concentration. [Table: see text]

scholarly journals Assessment of Deep Vein Thrombosis (DVT) incidence among ambulatory cancer patients in Qatar: A retrospective cohort study

2021 ◽  
Vol 16 (3) ◽  
pp. 049-058
Author(s):  
Rehab Abdelwahab ◽  
Anas Hamad ◽  
Reham Negm ◽  
Nayel Al Tarawneh ◽  
Shereen Elazzazy
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Deep Vein Thrombosis ◽  
Cancer Patients ◽  
Inpatient Setting ◽  
Additional Risk ◽  
Vein Thrombosis ◽  
Ambulatory Patients ◽  
Cancer Types ◽  
Deep Vein

Background: Thromboprophylaxis of ambulatory cancer patients is considered controversial. However, some guidelines suggest conducting VTE risk assessment using the Khorana risk assessment scoring model. This study aims to assess the incidence of Deep Vein Thrombosis (DVT) and related cancer types, focusing on the incidence of DVT in ambulatory patients actively on chemotherapy, with Khorana risk score (KRS). Methods: The Doppler ultrasound reports over 12-month period were reviewed. A total of 205 patients were included in the study. Patients with DVT were screened for the relevant biomarkers in KRS model and any other additional risk factors. Furthermore, a comparison between ambulatory patients who developed DVT and those who did not, was carried on determining the KRS association with incidence. Results: The incidence of DVT in ambulatory cancer patients was higher than the inpatient setting (23% vs. 8%). Breast cancer was the most common malignancy associated with DVT (30%) followed by colon cancer (17%). Chemotherapy increased the incidence of DVT in ambulatory patients (29% vs. 13%). Patients with KRS of ≥2 were more likely to develop DVT (37.5%). Conclusion: This study highlights the importance of conducting a thorough DVT risk assessment for ambulatory cancer patients on chemotherapy and the need to look for KRS to reconsider additional risk factors.

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