Incidence of venous thromboembolism and bleeding in patients with malignant central nervous system neoplasm: Systematic review and meta-analysis.

Autor: Veiga VC; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil., Peres SV; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil., Ostolin TLVDP; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil., Moraes FR; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil., Belucci TR; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil., Clara CA; Hospital do Câncer de Barretos, São Paulo, Brasil., Cavalcanti AB; HCor-Research Institute, São Paulo, Brasil., Chaddad-Neto FEA; Universidade Federal de São Paulo, São Paulo, Brasil., Batistella GNR; HCor-Research Institute, São Paulo, Brasil., Neville IS; Instituto do Câncer de São Paulo, São Paulo, Brasil., Baeta AM; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil., Yamada CAF; BP-A Beneficência Portuguesa de São Paulo, São Paulo, Brasil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jun 20; Vol. 19 (6), pp. e0304682. Date of Electronic Publication: 2024 Jun 20 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0304682
Abstrakt: Central nervous system (CNS) malignant neoplasms may lead to venous thromboembolism (VTE) and bleeding, which result in rehospitalization, morbidity and mortality. We aimed to assess the incidence of VTE and bleeding in this population.
Methods: This systematic review and meta-analysis (PROSPERO CRD42023423949) were based on a standardized search of PubMed, Virtual Health Library and Cochrane (n = 1653) in July 2023. After duplicate removal, data screening and collection were conducted by independent reviewers. The combined rates and 95% confidence intervals for the incidence of VTE and bleeding were calculated using the random effects model with double arcsine transformation. Subgroup analyses were performed based on sex, age, income, and type of tumor. Heterogeneity was calculated using Cochran's Q test and I2 statistics. Egger's test and funnel graphs were used to assess publication bias.
Results: Only 36 studies were included, mainly retrospective cohorts (n = 30, 83.3%) from North America (n = 20). Most studies included were published in high-income countries. The sample size of studies varied between 34 and 21,384 adult patients, mostly based on gliomas (n = 30,045). For overall malignant primary CNS neoplasm, the pooled incidence was 13.68% (95%CI 9.79; 18.79) and 11.60% (95%CI 6.16; 18.41) for VTE and bleeding, respectively. The subgroup with elderly people aged 60 or over had the highest incidence of VTE (32.27% - 95%CI 14.40;53.31). The studies presented few biases, being mostly high quality. Despite some variability among the studies, we observed consistent results by performing sensitivity analysis, which highlight the robustness of our findings.
Conclusions: Our study showed variability in the pooled incidence for both overall events and subgroup analyses. It was highlighted that individuals over 60 years old or diagnosed with GBM had a higher pooled incidence of VTE among those with overall CNS malignancies. It is important to note that the results of this meta-analysis refer mainly to studies carried out in high-income countries. This highlights the need for additional research in Latin America, and low- and middle-income countries.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Veiga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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