Division of Hematology, Rutgers Robert Wood Johnson Medical School, New Brunswick.
Department of Biostatistics, Rutgers School of Public Health, Piscataway.
Blood Coagul Fibrinolysis. 2023 Sep 1;34(6):345-352. doi: 10.1097/MBC.0000000000001226. Epub 2023 Jul 6.
Risk factors for venous thromboembolism (VTE) in elderly patients with acute myeloid leukemia (AML) are not known by race. The aim of this study was to determine the association of VTE with known risk factors and the impact of VTE on mortality in elderly white, black and Asian patients with AML. The merged SEER-Medicare database (2000-2015) was used for patients aged at least 65 years diagnosed with AML. Multivariable logistic regression was used to examine the association of VTE with known risk factors and Cox proportional hazards regression was used to evaluate the association of VTE with mortality in white, black and Asian patients. Among 21 403 AML patients aged at least 65years, VTE was diagnosed in 10.6% of 18 731 white patients, 13.4% of 1362 black and 5.6% of 1310 Asian patients. Overall, the adjusted risk of VTE in black patients was similar to white patients, but Asian patients had a lower risk of VTE. Risk factors for VTE in white patients were age less than 75 years, female sex, chemotherapy and comorbid medical conditions, including hypertension, anemia, chronic kidney and lung disease, hyperlipidemia, heart failure and obesity. In black patients, hyperlipidemia, and heart failure and in Asian patients, age less than 75 years, female sex, chemotherapy and hypertension and myocardial infarction were associated with VTE. Central venous catheter placement was a predictor of VTE in all three races. Our study identified risk factors for VTE by race in elderly white, black and Asian AML patients.
老年急性髓系白血病(AML)患者静脉血栓栓塞症(VTE)的风险因素与种族无关。本研究旨在确定 VTE 与已知危险因素的相关性,以及 VTE 对老年白种人、黑人和亚洲人 AML 患者死亡率的影响。使用合并的 SEER-Medicare 数据库(2000-2015 年)对年龄至少 65 岁被诊断为 AML 的患者进行分析。采用多变量逻辑回归分析 VTE 与已知危险因素的相关性,采用 Cox 比例风险回归分析 VTE 与白种人、黑人和亚洲人死亡率的相关性。在 21403 名年龄至少 65 岁的 AML 患者中,18731 名白种人中有 10.6%、1362 名黑种人中有 13.4%、1310 名亚洲人中有 5.6%被诊断为 VTE。总体而言,黑种人患者 VTE 的调整风险与白种人相似,但亚洲人患者 VTE 的风险较低。白种人患者 VTE 的危险因素为年龄<75 岁、女性、化疗和合并的医疗状况,包括高血压、贫血、慢性肾脏和肺部疾病、高血脂、心力衰竭和肥胖症。在黑种人患者中,高血脂症和心力衰竭,以及在亚洲人患者中,年龄<75 岁、女性、化疗和高血压以及心肌梗死与 VTE 相关。中心静脉导管置管是三种人群 VTE 的预测因素。本研究确定了老年白种人、黑人和亚洲人 AML 患者中 VTE 的种族相关危险因素。