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癌症相关静脉血栓栓塞症:不同种族人群中的发生率和特征。

Cancer-associated venous thromboembolism: Incidence and features in a racially diverse population.

机构信息

Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

Department of Health Administration and Policy, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

出版信息

J Thromb Haemost. 2022 Oct;20(10):2366-2378. doi: 10.1111/jth.15818. Epub 2022 Aug 7.

Abstract

BACKGROUND

Data on the population-based incidence of cancer-associated venous thromboembolism (VTE) from racially diverse populations are limited.

OBJECTIVE

To evaluate the incidence and burden of cancer-associated VTE, including demographic and racial subgroups in the general population of Oklahoma County-which closely mirrors the United States.

DESIGN

A population-based prospective study.

SETTING

We conducted surveillance of VTE at tertiary care facilities and outpatient clinics in Oklahoma County, Oklahoma, from 2012-2014. Surveillance included reviewing all imaging reports used to diagnose VTE and identifying VTE events from hospital discharge data and death certificates. Cancer status was determined by linkage to the Oklahoma Central Cancer Registry.

MEASUREMENTS

We used Poisson regression to calculate crude and age-adjusted incidence rates of cancer-associated VTE per 100 000 general population per year, with 95% confidence intervals (95% CI).

RESULTS

The age-adjusted incidence (95% CI) of cancer-associated VTE among adults age ≥ 18 was 70.0 (65.1-75.3). The age-adjusted incidence rates (95% CI) were 85.9 (72.7-101.6) for non-Hispanic Blacks, 79.5 (13.2-86.5) for non-Hispanic Whites, 18.8 (8.9-39.4) for Native Americans, 15.6 (7.0-34.8) for Asian/Pacific Islanders, and 15.2 (9.2-25.1) for Hispanics. Recurrent VTE up to 2 years after the initial diagnosis occurred in 38 of 304 patients (12.5%) with active cancer and in 34 of 424 patients (8.0%) with a history of cancer > 6 months previously.

CONCLUSION

Age-adjusted incidence rates of cancer-associated VTE vary substantially by race and ethnicity. The relatively high incidence rates of first VTE and of recurrence warrant further assessment of strategies to prevent VTE among cancer patients.

摘要

背景

来自不同种族人群的癌症相关静脉血栓栓塞症(VTE)的基于人群的发病数据有限。

目的

评估俄克拉荷马县普通人群中癌症相关 VTE 的发病率和负担,包括人口统计学和种族亚组-这与美国非常相似。

设计

一项基于人群的前瞻性研究。

地点

我们在俄克拉荷马州俄克拉荷马县的三级保健设施和门诊诊所进行 VTE 的监测,时间为 2012-2014 年。监测包括审查用于诊断 VTE 的所有影像学报告,并从医院出院数据和死亡证明中确定 VTE 事件。癌症状态通过与俄克拉荷马州中央癌症登记处的链接确定。

测量方法

我们使用泊松回归计算每 10 万普通人群每年每 100000 人癌症相关 VTE 的粗发病率和年龄调整发病率,置信区间为 95%(95%CI)。

结果

年龄调整后的发病率(95%CI)为年龄≥18 岁的成年人中的癌症相关 VTE 为 70.0(65.1-75.3)。非西班牙裔黑人的年龄调整发病率(95%CI)为 85.9(72.7-101.6),非西班牙裔白人的年龄调整发病率(95%CI)为 79.5(13.2-86.5),美洲原住民的年龄调整发病率(95%CI)为 18.8(8.9-39.4),亚裔/太平洋岛民的年龄调整发病率(95%CI)为 15.6(7.0-34.8),西班牙裔的年龄调整发病率(95%CI)为 15.2(9.2-25.1)。在 304 例有活动性癌症的患者中,有 38 例(12.5%)和在 424 例有>6 个月既往癌症史的患者中,有 34 例(8.0%)在初始诊断后 2 年内发生复发性 VTE。

结论

癌症相关 VTE 的年龄调整发病率因种族和族裔而异。首次 VTE 和复发的相对较高发生率需要进一步评估预防癌症患者 VTE 的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a718/9804159/0374c77fe4ed/JTH-20-2366-g001.jpg

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