scholarly journals Risk Factors and Prediction Models for Venous Thromboembolism in Ambulatory Patients with Lung Cancer

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 778
Author(s):  
Ann-Rong Yan ◽  
Indira Samarawickrema ◽  
Mark Naunton ◽  
Gregory M. Peterson ◽  
Desmond Yip ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Prediction Models ◽  
Poor Performance ◽  
Risk Models ◽  
Related Risk ◽  
Wide Range ◽  
Ambulatory Patients

Venous thromboembolism (VTE) is a significant cause of mortality in patients with lung cancer. Despite the availability of a wide range of anticoagulants to help prevent thrombosis, thromboprophylaxis in ambulatory patients is a challenge due to its associated risk of haemorrhage. As a result, anticoagulation is only recommended in patients with a relatively high risk of VTE. Efforts have been made to develop predictive models for VTE risk assessment in cancer patients, but the availability of a reliable predictive model for ambulate patients with lung cancer is unclear. We have analysed the latest information on this topic, with a focus on the lung cancer-related risk factors for VTE, and risk prediction models developed and validated in this group of patients. The existing risk models, such as the Khorana score, the PROTECHT score and the CONKO score, have shown poor performance in external validations, failing to identify many high-risk individuals. Some of the newly developed and updated models may be promising, but their further validation is needed.

Risk of venous thromboembolism and primary prophylaxis in cancer

2012 ◽  
Vol 32 (02) ◽  
pp. 132-137 ◽  
Author(s):  
C. Ay ◽  
I. Pabinger
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Cancer Patients ◽  
Prediction Models ◽  
Critical Evaluation ◽  
Primary Prophylaxis ◽  
Vte Prophylaxis ◽  
Related Risk ◽  
Hospitalised Patients

SummaryVenous thromboembolism (VTE) is a common complication in patients with cancer that causes significant morbidity and mortality. Several patient-, tumour-and treatment-related risk factors for VTE in cancer patients have been identified. An effective and safe thromboprophylaxis in cancer patients at high risk of VTE is desirable. Recently, the identification of potential biomarkers and the development of risk scoring models for prediction of cancer-associated VTE have been published. Whether primary VTE prophylaxis based on risk assessment through these biomarkers and risk prediction models might be useful, is currently not yet known. However, thromboprophylaxis is clearly indicated in high-risk situations. While VTE prophylaxis is recommended in cancer patients undergoing surgery and in hospitalised patients with acute disease, studies in ambulatory cancer patients are still rare and evidence for primary VTE prophylaxis is currently limited. In this review, risk factors associated with VTE in cancer patients and current approaches of thromboprophylaxis in different settings, specifically in ambulatory cancer patients are subjected to a critical evaluation.

Risk of venous thromboembolism and primary prophylaxis in cancer

2012 ◽  
Vol 03 (03) ◽  
pp. 115-120
Author(s):  
C. Ay ◽  
I. Pabinger
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Cancer Patients ◽  
Prediction Models ◽  
Critical Evaluation ◽  
Primary Prophylaxis ◽  
Vte Prophylaxis ◽  
Related Risk ◽  
Hospitalised Patients

SummaryVenous thromboembolism (VTE) is a common complication in patients with cancer that causes significant morbidity and mortality. Several patient-, tumour- and treatment-related risk factors for VTE in cancer patients have been identified. An effective and safe thromboprophylaxis in cancer patients at high risk of VTE is desirable. Recently, the identification of potential biomarkers and the development of risk scoring models for prediction of cancer-associated VTE have been published. Whether primary VTE prophylaxis based on risk assessment through these biomarkers and risk prediction models might be useful, is currently not yet known. However, thromboprophylaxis is clearly indicated in high-risk situations. While VTE prophylaxis is recommended in cancer patients undergoing surgery and in hospitalised patients with acute disease, studies in ambulatory cancer patients are still rare and evidence for primary VTE prophylaxis is currently limited. In this review, risk factors associated with VTE in cancer patients and current approaches of thromboprophylaxis in different settings, specifically in ambulatory cancer patients are subjected to a critical evaluation.

scholarly journals Models for predicting venous thromboembolism in ambulatory patients with lung cancer: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055322
Author(s):  
Ann-Rong Yan ◽  
Indira Samarawickrema ◽  
Mark Naunton ◽  
Gregory M Peterson ◽  
Desmond Yip ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Risk Prediction ◽  
Prediction Models ◽  
Data Extraction ◽  
Cochrane Library ◽  
Risk Prediction Models ◽  
Ambulatory Patients

IntroductionVenous thromboembolism (VTE) is a common complication in patients with cancer and has a determining role in the disease prognosis. The risk is significantly increased with certain types of cancer, such as lung cancer. Partly due to difficulties in managing haemorrhage in outpatient settings, anticoagulant prophylaxis is only recommended for ambulatory patients at high risk of VTE. This requires a precise VTE risk assessment in individual patients. Although VTE risk assessment models have been developed and updated in recent years, there are conflicting reports on the effectiveness of such risk prediction models in patient management. The aim of this systematic review is to gain a better understanding of the available VTE risk assessment tools for ambulatory patients with lung cancer and compare their predictive performance.Methods and analysisA systematic review will be conducted using MEDLINE, Cochrane Library, CINAHL, Scopus and Web of Science databases from inception to 30 September 2021, to identify all reports published in English describing VTE risk prediction models which have included adult ambulatory patients with primary lung cancer for model development and/or validation. Two independent reviewers will conduct article screening, study selection, data extraction and quality assessment of the primary studies. Any disagreements will be referred to a third researcher to resolve. The included studies will be assessed for risk of bias and applicability. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies will be used for data extraction and appraisal. Data from similar studies will be used for meta-analysis to determine the incidence of VTE and the performance of the risk models.Ethics and disseminationEthics approval is not required. We will disseminate the results in a peer-reviewed journal.PROSPERO registration numberCRD42021245907.

scholarly journals Screening for Occult Cancer in Patients with Venous Thromboembolism: Past, Present, and Future

2020 ◽  
Vol 40 (03) ◽  
pp. 270-279
Author(s):  
Nick van Es ◽  
Cihan Ay ◽  
Luis Jara-Palomares
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Cancer Diagnosis ◽  
Prediction Models ◽  
Liquid Biopsies ◽  
Ongoing Research ◽  
Occult Cancer ◽  
Screening Strategies ◽  
Risk Of Cancer

AbstractA strong link between cancer and thrombosis has been well recognized. The occurrence of venous thromboembolism (VTE) can be the first clinical sign of an undiagnosed (i.e., occult) cancer. Cancer is more often diagnosed after unprovoked compared with provoked VTE events, with a reported risk in recent studies of around 5%. Extensive, imaging-based screening strategies to detect occult cancer after unprovoked VTE do not appear to have a clear clinical benefit compared with a more limited cancer screening. To identify patients with unprovoked VTE at high risk of occult cancer, risk factors have been explored and prediction models developed. Relevant risk factors for occult cancer include male sex, age, anemia, chronic lung disease, and thrombocytosis. Studies with preselection of patients based on risk assessment and evaluation of limited versus extensive screening strategies are currently ongoing. Also, novel and promising approaches for early detection of cancer in patients with unprovoked VTE by means of liquid biopsies, which include analysis of circulating tumor cells, cell-free tumor DNA, proteomics, or platelet mRNA sequencing, are currently under investigation. In this review, we provide an overview of the risk of cancer diagnosis after VTE, discuss the studies which investigated different screening strategies for occult cancer, summarize risk factors and risk scoring models for identification of patients at high risk of cancer diagnosis after VTE, and highlight ongoing research to optimize screening and identification of patients at risk of occult cancer, which will shape the future clinical practice.

Prediction of 10-year and lifetime risk of cancer in individual patients with established cardiovascular disease, results from UCC-SMART and CANTOS

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Van 't Klooster ◽  
P.M Ridker ◽  
N.R Cook ◽  
J.G.J.V Aerts ◽  
J Westerink ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Lung Cancer ◽  
Cancer Risk ◽  
Prediction Models ◽  
Funding Source ◽  
Cancer Models ◽  
Total Cancer ◽  
The Cantos ◽  
Risk Of Cancer

Abstract Background As treatment for cardiovascular disease (CVD) has improved substantially over the last decades, more patients survive acute CVD manifestations and are at risk for developing cancer as well as recurrent CVD. Due to similar risk factors, including smoking and obesity, patients with established CVD are at higher risk for cancer. Objectives The aim of this study was to develop and externally validate prediction models for the estimation of 10-year and lifetime risk for total, colorectal, and lung cancer in patients with established CVD. Methods Data from patients with established CVD from the UCC-SMART prospective cohort study (N=7,280) were used for model development, and data from the CANTOS trial (N=9,322) were used for model validation. Predictors were selected based on previously published cancer risk prediction models or cancer risk factors, easy clinical availability, and availability in the derivation dataset (UCC-SMART cohort). A Fine and Gray competing risk-adjusted lifetime model was developed for total, colorectal, and lung cancer. Results Selected predictors were age, sex, smoking status, weight, height, alcohol use, antiplatelet use, diabetes mellitus, and C-reactive protein. External calibration for 4-year risks of the total cancer, colorectal cancer, and lung cancer models was good (Figure 1), and C-statistics were 0.63–0.74 in the CANTOS trial population. Median predicted lifetime risks in CANTOS were 26% (range 1%-52%) for total cancer, 4% (range 0%-13%) for colorectal cancer, and 5% (range 0%-37%) for lung cancer. Conclusions Lifetime and 10-year risk of cancer can be estimated with easy to measure variables in patients with established CVD, showing a wide distribution of predicted lifetime risks for total cancer and lung cancer. Using these lifetime models in clinical practice could increase understanding of cancer risk and aid in emphasizing healthy lifestyle changes. Figure 1. Calibration plots of cancer models Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Medical Center; Additional funding: CANTOS trial was funded by Novartis Pharmaceuticals.

scholarly journals Forty-One-Year-Old Man with Pulmonary Embolism 5 Months After COVID-19

2021 ◽  
Vol 15 ◽  
pp. 117954842098665
Author(s):  
Muhanad Taha ◽  
Paul Nguyen ◽  
Aditi Sharma ◽  
Mazen Taha ◽  
Lobelia Samavati
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Venous Thrombosis ◽  
Case Summary ◽  
One Year

Background: Hypercoagulation is one of the striking features of COVID-19. Patients hospitalized with COVID-19 are at high risk for venous thromboembolism. However, it is unknown if the risk for venous thromboembolism persists after discharge. Case Summary: We report a case with pulmonary embolism 5 months after COVID-19. No risk factors for venous thrombosis have been identified. Conclusion: In COVID-19 related hospitalization, large studies are needed to identify the risk of venous thromboembolism after discharge.

scholarly journals ARTERIAL HYPERTENSION AND RISK FACTORS IN CHILDREN: LITERATURE REVIEW

2020 ◽  
Vol 18 (5) ◽  
pp. 523-531
Author(s):  
N. A. Maхimovich ◽  
◽  
A. V. Luksha ◽  
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
High Risk ◽  
Young People ◽  
Literature Review ◽  
Arterial Hypertension ◽  
Qualitative Analysis ◽  
Environmental Risk ◽  
Modern Society ◽  
Related Risk

Background. In modern society, there is an intensive increase in the incidence of arterial hypertension among young people, which is mainly due to lifestyle characteristics and related risk factors.Objective: to analyze the results of scientific researches of domestic and foreign authors regarding the study of risk factors in the development of arterial hypertension in children.Material and methods. A qualitative analysis of the current literature data on the risk factors for arterial hypertension and its prevention has been carried out.Results. It has been established that the occurrence of arterial hypertension in childhood is due to not only hereditary, but also a number of environmental risk factors.Conclusions. Further researches are needed to study new and established risk factors that must be considered when conducting primary prevention of the disease in children at high risk.

scholarly journals Metabolome-defined obesity and the risk of future diabetes and mortality

2021 ◽  
Author(s):  
Filip Ottosson ◽  
Einar Smith ◽  
Ulrika Ericson ◽  
Salvatore Di Somma ◽  
Paola Antonini ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Population Based ◽  
Normal Weight ◽  
Plasma Metabolites ◽  
Italian Population ◽  
Related Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Future Diabetes

Background Obesity is a key risk factor for type 2 diabetes, however, up to 20% of patients are normal weight. Our aim was to identify metabolite patterns reproducibly predictive of BMI, and subsequently to test if lean individuals who carry an obese metabolome are at hidden high risk of obesity related diseases, such as diabetes. Methods We measured 109 metabolites in fasted plasma samples of 7663 individuals from two Swedish and one Italian population-based cohort. Ridge regression models were used to predict BMI using the plasma metabolites. Individuals with a predicted BMI either more than 5 kg/m2 higher (overestimated) or lower (underestimated) than their actual BMI were characterized as outliers and further investigated for obesity related risk factors and future risk of diabetes and mortality. Results The plasma metabolome could predict BMI in all cohorts (r2 = 0.48, 0.26 and 0.19). The overestimated group had a BMI similar to individuals correctly predicted as normal weight, similar waist circumference, were not more likely to change weight over time but had a 2 times higher risk of future diabetes and an 80 % increased risk of all-cause mortality. These associations remained after adjustments for obesity-related risk factors and lifestyle parameters. Conclusions We found that lean individuals with an obese metabolome, have an increased risk for diabetes and all-cause mortality compared to lean individuals with a healthy metabolome. Metabolomics may be used to identify hidden high-risk individuals, in order to initiate lifestyle and pharmacological interventions.

Epidemiology of cancer-associated venous thrombosis

Blood ◽  
2013 ◽  
Vol 122 (10) ◽  
pp. 1712-1723 ◽  
Author(s):  
Jasmijn F. Timp ◽  
Sigrid K. Braekkan ◽  
Henri H. Versteeg ◽  
Suzanne C. Cannegieter
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Prediction Models ◽  
Related Factors ◽  
Treatment Measures ◽  
Risk Patients ◽  
Cancer Types

Abstract Cancer-associated venous thrombosis is a common condition, although the reported incidence varies widely between studies depending on patient population, start and duration of follow-up, and the method of detecting and reporting thrombotic events. Furthermore, as cancer is a heterogeneous disease, the risk of venous thrombosis depends on cancer types and stages, treatment measures, and patient-related factors. In general, cancer patients with venous thrombosis do not fare well and have an increased mortality compared with cancer patients without. This may be explained by the more aggressive type of malignancies associated with this condition. It is hypothesized that thromboprophylaxis in cancer patients might improve prognosis and quality of life by preventing thrombotic events. However, anticoagulant treatment leads to increased bleeding, particularly in this patient group, so in case of proven benefit of thromboprophylaxis, only patients with a high risk of venous thrombosis should be considered. This review describes the literature on incidence of and risk factors for cancer-associated venous thrombosis, with the aim to provide a basis for identification of high-risk patients and for further development and refinement of prediction models. Furthermore, knowledge on risk factors for cancer-related venous thrombosis may enhance the understanding of the pathophysiology of thrombosis in these patients.

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