Darweesh Mohammad, Haddaden Metri, Fatima Zainab, Mansour Mahmoud, Dalbah Rami, Fahmawi Suhib, Mahfouz Ratib, Obeidat Adham E, Gajjar Bhavesh
Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
Department of Internal Medicine, Griffin Hospital, Yale University School of Medicine, Derby, CT, USA.
Gastrointest Tumors. 2024 Jun 11;10(1):67-73. doi: 10.1159/000538057. eCollection 2023 Jan-Dec.
Venous thromboembolism (VTE) is associated with significant morbidity and mortality in cancer patients. Our study compares the mortality in hospitalized VTE patients among the four most common gastrointestinal (GI) malignancies which include esophageal, gastric, pancreatic, and colorectal cancer.
A retrospective study was conducted utilizing the Nationwide Inpatient Sample database (NIS) from 2016 to 2019. Patients with VTE were identified using ICD-10 codes from all primary discharge diagnoses. Only deep venous thrombosis (DVT) and pulmonary embolism (PE) were considered. Patients with VTE were further divided into groups: esophageal cancer, gastric cancer, pancreatic cancer, and colorectal cancer, and compared with patients who did not have these malignancies. The adjusted odds ratio (aOR) was calculated using multivariate regression analysis.
Among 999,559 patients discharged with a VTE diagnosis, 25,775 (2.6%) had one of the four GI malignancies. Among patients with one of the four included GI malignancy diagnosis, 18,816 (73%) patients had PE and 6,959 (27%) patients had DVT. The study shows that adults admitted to the hospitals for VTE have higher mortality when compared to patients who did not have GI malignancies, with esophageal cancer having the highest inpatient mortality with an aOR of 2.701; 95% confidence interval (CI) 1.989-3.669, value <0.000. For the remaining GI cancers, gastric cancer had an aOR 1.576; CI: 1.094-2.269, value 0.015, and pancreatic cancer had an aOR of 1.736; 95% CI: 1.445-2.085, value <0.000. Patients with colorectal cancer had no significant increase in the odds of mortality with aOR of 1.213; 95% CI: 0.988-1.489, value 0.066.
This study demonstrates that VTE in hospitalized patients with esophageal cancer is associated with greater mortality compared to other GI malignancies.
静脉血栓栓塞症（VTE）与癌症患者的高发病率和死亡率相关。我们的研究比较了四种最常见的胃肠道（GI）恶性肿瘤（包括食管癌、胃癌、胰腺癌和结直肠癌）住院VTE患者的死亡率。
利用2016年至2019年的全国住院患者样本数据库（NIS）进行回顾性研究。使用所有主要出院诊断中的ICD-10编码识别VTE患者。仅考虑深静脉血栓形成（DVT）和肺栓塞（PE）。VTE患者进一步分为以下组：食管癌、胃癌、胰腺癌和结直肠癌，并与没有这些恶性肿瘤的患者进行比较。使用多变量回归分析计算调整后的优势比（aOR）。
在999,559例诊断为VTE出院的患者中，25,775例（2.6%）患有四种胃肠道恶性肿瘤之一。在四种纳入的胃肠道恶性肿瘤诊断之一的患者中，18,816例（73%）患者患有PE，6,959例（27%）患者患有DVT。研究表明，与没有胃肠道恶性肿瘤的患者相比，因VTE入院的成年人死亡率更高，食管癌的住院死亡率最高，aOR为2.701；95%置信区间（CI）为1.989 - 3.669，P值<0.000。对于其余胃肠道癌症，胃癌的aOR为1.576；CI：1.094 - 2.269，P值为0.015，胰腺癌的aOR为1.736；95%CI：1.445 - 2.085，P值<0.000。结直肠癌患者的死亡几率没有显著增加，aOR为1.213；95%CI：0.988 - 1.489，P值为0.066。
本研究表明，与其他胃肠道恶性肿瘤相比，食管癌住院患者的VTE与更高的死亡率相关。
