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在美国,导管定向溶栓治疗对癌症合并静脉血栓栓塞患者再入院率和住院结局的影响。

The effect of catheter-directed thrombolytic use on readmission rates and in-hospital outcomes among cancer patients with venous thromboembolism in the United States.

作者信息

Guha Avirup, McKinley Grant, Dey Amit K, Carter Rebecca, Miller P Elliott, Deshmukh Abhishek J, Zaghlol Raja, Barac Ana, Desai Nihar R, Addison Daniel

机构信息

Cardio-Oncology Program, Division of Cardiology, The Ohio State University, Columbus, Ohio.

Division of Cardiology, Harrington Heart and Vascular Institute, Cleveland, Ohio.

出版信息

J Card Surg. 2020 Mar;35(3):609-611. doi: 10.1111/jocs.14444. Epub 2020 Feb 3.

Abstract

BACKGROUND

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.

METHODS

We created a new cohort using discharge-level data from all hospitalizations from State Inpatient Databases of geographically dispersed participating states (18-27 states).

RESULTS

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.

CONCLUSION

The use of CDL does not appear to reduce the risk of returning for a VTE-related admission in cancer.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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