Bleeding and venous thromboembolic events in patients with active cancer hospitalized for an acute medical illness.

Di Nisio, Marcello; Candeloro, Matteo; Rutjes, Anne Wilhelmina Saskia; Galli, Valerio; Tritto, Marcello; Porreca, Ettore (2018). Bleeding and venous thromboembolic events in patients with active cancer hospitalized for an acute medical illness. Thrombosis research, 169, pp. 44-49. Elsevier 10.1016/j.thromres.2018.07.010

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BACKGROUND Cancer patients hospitalized for an acute medical illness are considered to be at high risk of venous thromboembolism (VTE). Information on bleeding and symptomatic VTE in these patients remains scant. The objectives of this study were to evaluate the incidence of bleeding and VTE during hospitalization and after discharge in a prospective cohort of hospitalized medically-ill cancer patients. METHODS Consecutive patients with active cancer admitted for an acute medical illness. The primary outcome was the incidence of clinically relevant bleeding. Secondary outcomes included symptomatic and incidentally detected VTE. Outcomes were recorded during hospitalization up to three months after discharge. RESULTS The study population consisted of 330 patients with a mean age of 73.2 (±12.1) years. During a median hospitalization of eight days, six patients (1.8%) developed a clinically relevant bleeding. Pharmacological thromboprophylaxis was administered to four of these six patients (66.6%), and 108 of 324 (33.3%) patients without bleeding. Twelve (3.6%) were diagnosed with VTE, of whom two had received thromboprophylaxis. In ten patients, VTE was detected incidentally. After discharge, 11 patients experienced major bleeding and two developed symptomatic VTE during a median follow-up of 92 days (range 19-110). Two thirds of all major bleeding events were gastrointestinal, and 87% occurred in patients with gastrointestinal or genitourinary cancer. CONCLUSIONS In patients with active cancer admitted for an acute medical illness, the risk of bleeding and symptomatic VTE appeared to be low during hospitalization. After discharge, the risk of bleeding was higher and significantly outweighed that of VTE.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Rutjes, Anne

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0049-3848

Publisher:

Elsevier

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

19 Jul 2018 14:08

Last Modified:

24 Oct 2019 07:12

Publisher DOI:

10.1016/j.thromres.2018.07.010

PubMed ID:

30015227

Uncontrolled Keywords:

Hemorrhage Hospitalization Neoplasm Prospective studies Venous thromboembolism

BORIS DOI:

10.7892/boris.118765

URI:

https://boris.unibe.ch/id/eprint/118765

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