Guha Avirup, McKinley Grant, Dey Amit K, Carter Rebecca, Miller P Elliott, Deshmukh Abhishek J, Zaghlol Raja, Barac Ana, Desai Nihar R, Addison Daniel
Cardio-Oncology Program, Division of Cardiology, The Ohio State University, Columbus, Ohio.
Division of Cardiology, Harrington Heart and Vascular Institute, Cleveland, Ohio.
J Card Surg. 2020 Mar;35(3):609-611. doi: 10.1111/jocs.14444. Epub 2020 Feb 3.
Cancer inducing a hypercoagulable state, venous thromboembolism (VTE) remains a leading cause of morbidity and mortality globally. We assessed the impacts of cancer on the likelihood for readmission after a VTE-targeted procedure.
We created a new cohort using discharge-level data from all hospitalizations from State Inpatient Databases of geographically dispersed participating states (18-27 states).
In those presenting with VTE during index-admission (619 241), 2.4% patients underwent catheter directed thrombolytic therapy (CDL) on index admission and among those 20.3% had cancer. Moreover, the 30-day readmission rate amongst CDL recipients (10 776 overall) was 14.3% in those with cancer compared to 8.8% in those with no cancer history (P < .0001). Additionally, in-hospital mortality (5.7% vs 1.1%; P = 0.009) and cost-of-care ($11 014 ± 914 vs $10 520 ± 534; P = .04) was significantly higher in cancer compared to noncancer.
The use of CDL does not appear to reduce the risk of returning for a VTE-related admission in cancer.
癌症可引发高凝状态，静脉血栓栓塞症（VTE）仍是全球发病和死亡的主要原因。我们评估了癌症对VTE靶向治疗后再入院可能性的影响。
我们使用来自地理上分散的参与州（18 - 27个州）的州住院数据库中所有住院患者的出院数据创建了一个新队列。
在首次入院时出现VTE的患者（619241例）中，2.4%的患者在首次入院时接受了导管定向溶栓治疗（CDL），其中20.3%患有癌症。此外，在接受CDL治疗的患者（共10776例）中，癌症患者的30天再入院率为14.3%，而无癌症病史的患者为8.8%（P < 0.0001）。此外，癌症患者的住院死亡率（5.7%对1.1%；P = 0.009）和护理费用（11014 ± 914美元对10520 ± 534美元；P = 0.04）明显高于非癌症患者。
在癌症患者中，使用CDL似乎并不能降低因VTE相关原因再次入院的风险。
