Conte Guillermo, Figueroa Gastón
Sección de Hematología, Hospital Clínico Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2008 Dec;136(12):1528-34. Epub 2009 Mar 23.
Hospitalized patients with cancer have a high risk of venous thromboembolism (VTE).
To study the frequency of VTE and its risk factors in hospitalized patients with cancer.
Retrospective analysis of clinical records of patients with cancer, hospitalized at a university hospital between 2002 and 2004. Patients with the diagnosis of VTE at admission or using anticoagulants, were excluded from the analysis.
The medical records of 366 patients were reviewed. Fifty three percent had a digestive cancer, 19% lung cancer, 10% breast cancer and 18% had a tumor of other origin. In 77%, the tumor was in an advanced stage. The most common admission diagnoses were pneumonia, vomiting and dehydration, gastrointestinal bleeding and urinary infection. In 125 patients (34%) pharmacological thrombo-prophylaxis was not used and 242 (66%) received regular or low molecular weight heparin. VTE was detected in 11 patients (3%) and was significantly more common among patients not receiving thrombo prophylaxis compared to those receiving heparin (6.4% and 1.2%, respectively p =0.014). Factors associated to VTE were a history of previous VTE with an odds ratio (OR) of 12.9 (p <0.01), obesity with an OR of 13.3 (p <0.01), recent chemotherapy with an OR of 6.9 (p =0.01). The use of pharmacological thromboprophylaxis had an OR of 0.24 (p =0.05).
Three percent of patients in this series had VTE during the hospitalization. Pharmacological thrombo-prophylaxis significantly reduced the risk of VTE.
癌症住院患者发生静脉血栓栓塞（VTE）的风险很高。
研究癌症住院患者VTE的发生率及其危险因素。
对2002年至2004年在一所大学医院住院的癌症患者的临床记录进行回顾性分析。入院时诊断为VTE或正在使用抗凝剂的患者被排除在分析之外。
对366例患者的病历进行了审查。53%患有消化道癌症，19%患有肺癌，10%患有乳腺癌，18%患有其他来源的肿瘤。77%的肿瘤处于晚期。最常见的入院诊断是肺炎、呕吐和脱水、胃肠道出血和尿路感染。125例患者（34%）未使用药物性血栓预防措施，242例患者（66%）接受了普通肝素或低分子肝素治疗。11例患者（3%）检测到VTE，未接受血栓预防措施的患者中VTE的发生率明显高于接受肝素治疗的患者（分别为6.4%和1.2%，p =0.014）。与VTE相关的因素包括既往VTE病史，比值比（OR）为12.9（p <0.01），肥胖，OR为13.3（p <0.01），近期化疗，OR为6.9（p =0.01）。使用药物性血栓预防措施的OR为0.24（p =0.05）。
本系列中3%的患者在住院期间发生了VTE。药物性血栓预防措施显著降低了VTE的风险。
