Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Support Care Cancer. 2019 Jul;27(7):2507-2515. doi: 10.1007/s00520-018-4537-y. Epub 2018 Nov 5.
The aim of this study was to estimate the incidence and predictors of venous thromboembolism (VTE) in medically ill hospitalized elderly cancer patients in a single Korean tertiary hospital.
Patients were examined for deep vein thrombosis (DVT) by duplex and color Doppler ultrasonography (DUS) of both legs between days 5 and 14 of their hospital stays. The primary endpoint was the incidence of VTE by day 14, which was determined via a composite of DVT detected by routine DUS and symptomatic VTE.
A total of 140 patients with 31 hematologic and 109 nonhematologic malignancies were analyzed. The median age was 73 years, and 45.7% of the patients were female. The median length of hospital stay was 12 days. The modified Padua prediction score (PPS) ≥ 4 was 92.9%. The incidence of VTE by day 14 was 7.1%, including six proximal and four distal DVT cases. Being female, having a length of hospital stay of ≥ 13 days, and having a modified Padua prediction score of ≥ 6 were risk factors of VTE in univariate analysis. The incidence of VTE was 2.3%, 7.3%, and 41.7% in patients with 0-1, 2, and 3 of these risk factors, respectively.
The incidence of VTE in medically ill hospitalized elderly cancer patients was lower in Korean patients than in Western patients. However, the risk of VTE in those with more than two risk factors (female, long length of hospitalization, and high PPS) increased considerably, and pharmacologic thromboprophylaxis is warranted in these cases.
本研究旨在评估一家韩国三级医院住院老年癌症患者的医学疾病相关静脉血栓栓塞症（VTE）发生率和预测因素。
患者在住院第 5 至 14 天期间，通过双下肢超声（DUS）和彩色多普勒超声（DUS）检查深静脉血栓形成（DVT）。主要终点为第 14 天的 VTE 发生率，通过常规 DUS 检测到的 DVT 和有症状 VTE 的综合情况来确定。
共分析了 140 例患有 31 例血液系统恶性肿瘤和 109 例非血液系统恶性肿瘤的患者。中位年龄为 73 岁，45.7%的患者为女性。中位住院时间为 12 天。改良 Padua 预测评分（PPS）≥4 者占 92.9%。第 14 天 VTE 的发生率为 7.1%，包括 6 例近端和 4 例远端 DVT 病例。女性、住院时间≥13 天和改良 Padua 预测评分≥6 是单因素分析中 VTE 的危险因素。在具有 0-1、2 和 3 个这些危险因素的患者中，VTE 的发生率分别为 2.3%、7.3%和 41.7%。
与西方患者相比，韩国住院老年癌症患者的 VTE 发生率较低。然而，具有两个以上危险因素（女性、长住院时间和高 PPS）的患者发生 VTE 的风险显著增加，这些患者需要进行药物预防血栓形成。
