Incidence, risk factors of symptomatic venous thromboembolism and risk prediction score in hospitalized cancer patients at Ubon Ratchathani Cancer Hospital

Abstract

Abstract

Introduction: Cancer patients have a higher risk for venous thromboembolism (VTE) which can lead to significant morbidity and mortality. Therefore, identifying high-risk groups for appropriate prevention is essential.

Objective: This study aimed to determine the incidence and risk factors for VTE in cancer patients receiving treatment at Ubon Ratchathani Cancer Hospital.

Methods: This prospective observational cohort study collected patient baseline data and followed-ups at 30, 60 and 90 days. Patients with suspected VTE, based on the Padua score and Caprini score, underwent Doppler ultrasonography or CT angiography. The calculated sample size was 185.

Results: Among 185 cancer patients, the incidence of VTE was 21.1%. The locations included the leg (52.6%), lungs (18.4%), neck (10.5%), abdomen (10%) and kidney (5.2%), while 2 patients died from pulmonary embolism. Patients with ECOG performance status (PS) grades 3-4 comprised 28.7%. The most common cancer type was gynecological (28.7%), followed by head and neck cancers (21.1%). Patients at stages 3-4  accounted for 68.1%, and 53% (98 patients) underwent surgery. Multivariable logistic regression analysis identified risk factors for VTE: female (adjusted odds ratio [AdjOR] = 3.87, 95% confidence interval [CI] = 1.46-10.27), ECOG PS grades 3-4 (AdjOR = 4.74, 95%CI = 1.82-12.32) and surgical intervention (AdjOR = 2.46, 95%CI = 1.01-5.96). Patients with 2 and 3 risk factors had VTE incidence rates of 19.2% and 67.9%, respectively.

Conclusion: VTE is a common complication among cancer patients. The risk factors included PS, sex and surgery. Patients with two or more of these factors should be considered for appropriate preventive measures.