Cancer associated thrombosis and mortality in patients with cancer stratified by khorana score risk levels

Autor: Keith R. McCrae, Sean D. MacKnight, Patrick Lefebvre, François Laliberté, Michael B. Streiff, Gary H. Lyman, Dejan Milentijevic, Guillaume Germain, Alok A. Khorana, Nicole M. Kuderer
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
Time Factors
Databases
Factual
medicine.medical_treatment
Population
lcsh:RC254-282
Decision Support Techniques
03 medical and health sciences
0302 clinical medicine
risk model
Risk Factors
Neoplasms
Internal medicine
Humans
Medicine
Radiology
Nuclear Medicine and imaging
education
Original Research
Aged
Retrospective Studies
Cancer
Aged
80 and over
education.field_of_study
Chemotherapy
business.industry
Hazard ratio
risk assessment
Venous Thromboembolism
Middle Aged
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
medical oncology
Radiation therapy
030104 developmental biology
clinical cancer research
Oncology
030220 oncology & carcinogenesis
Cohort
Female
business
Risk assessment
Algorithms
Cohort study
Zdroj: Cancer Medicine, Vol 9, Iss 21, Pp 8062-8073 (2020)
Cancer Medicine
ISSN: 2045-7634
DOI: 10.1002/cam4.3437
Popis: Background The Khorana score (KS) clinical algorithm is used to predict VTE risk in cancer patients. The study objective was to evaluate VTE and survival rates among patients newly diagnosed with cancer and stratified by KS in a real‐world population. Methods Data from the Optum® Clinformatics® DataMart database between 01/01/2012–09/30/2017 was used to identify adults with ≥ 1 hospitalization or ≥ 2 outpatient claims with a cancer diagnosis (index date). Only patients who were initiated on chemotherapy or radiation therapy were included. Patients were classified based on KS (KS = 0, 1, 2 or ≥ 3). Time‐to‐first VTE and survival were evaluated from the index date to the earliest among end of data availability or insurance coverage, death, or 12 months post‐index using Kaplan‐Meier (KM) analyses. Results A total of 2,488 (KS = 0); 2,125 (KS = 1), 1,074 (KS = 2), and 507 (KS ≥ 3) cancer patients were included. The 12‐month KM rates of VTE were 3.1%, 5.4%, 7.9%, and 14.9% (associated median time to VTE of 2.7, 3.0, 1.4, and 1.7 months) among KS = 0, 1, 2, and ≥ 3 cohorts, respectively. Corresponding adjusted hazard ratios (95% CIs) relative to the KS = 0 cohort were 1.72 (1.25‐2.38), 2.46 (1.73‐3.50), and 4.99 (3.40‐7.31) for the KS = 1, 2, and ≥ 3 cohorts, respectively (all P
This cohort study evaluated the risk of VTE and survival rates among patients newly diagnosed with cancer and stratified by Khorana score (KS) in a real‐world population. The present findings indicate that the rates of VTE significantly increased with KS, confirming its predictive ability. Moreover, VTE was associated with lower survival rates within each KS cohort.
Databáze: OpenAIRE
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