Strang Peter, Schultz Torbjörn
Department of Oncology-Pathology, Karolinska Institutet, Stockholms Sjukhem Foundation, Mariebergsgatan 22, SE 112 19 Stockholm, Sweden.
Research and Development Department, Stockholm's Sjukhem Foundation, Mariebergsgatan 22, SE 112 19 Stockholm, Sweden.
Cancers (Basel). 2024 Dec 1;16(23):4031. doi: 10.3390/cancers16234031.
BACKGROUND/OBJECTIVES: Venous thromboembolism (VTE) is associated with cancer, but we wanted to show VTE data for the last year of life, adjusting for age, sex, socioeconomic status and comorbidities. We also wanted to study the possible increase in VTE month by month, as well as time trends from 2015 to 2023.
A cohort of 27,423 deceased people with cancer were analyzed with -tests, chi-square tests and binary logistic regression models.
In total, 13.6% had at least one VTE episode during the last year of life and the VTE rate increased month by month ( < 0.0001). In adjusted models, higher VTE rates were associated with younger age and being a woman ( < 0.0001), both for all VTE as well as separately for pulmonary embolism (PE). The VTE rate increased by 47% from 11.1% in 2015 to 16.3% in 2023, and with significant differences for the pre-COVID-19 and COVID-19 years (i.e., 2015-2019 compared to 2020-2023, < 0.0001).
VTE is common in the last year of life and increases month by month. Higher frequencies are associated with female sex but especially with being younger, or having certain cancer forms such as pancreatic, gynecologic or lung cancer. The rate of VTE increased from 2015 to 2023. This is of interest as VTE has been associated with higher treatment intensity and with poorer prognosis and should be considered in the decision-making process.
背景/目的：静脉血栓栓塞症（VTE）与癌症相关，但我们希望展示生命最后一年的VTE数据，并对年龄、性别、社会经济地位和合并症进行调整。我们还希望研究VTE逐月可能的增加情况，以及2015年至2023年的时间趋势。
对27423名已故癌症患者队列进行t检验、卡方检验和二元逻辑回归模型分析。
总体而言，13.6%的患者在生命的最后一年至少发生过一次VTE事件，且VTE发生率逐月增加（P<0.0001）。在调整模型中，较高的VTE发生率与较年轻的年龄和女性相关（P<0.0001），无论是所有VTE情况还是单独的肺栓塞（PE）情况。VTE发生率从2015年的11.1%增加到2023年的16.3%，增加了47%，并且在COVID-19之前和COVID-19期间（即2015 - 2019年与2020 - 2023年）存在显著差异（P<0.0001）。
VTE在生命的最后一年很常见，且逐月增加。较高的发生率与女性性别相关，但尤其与较年轻的年龄或患有某些癌症类型（如胰腺癌、妇科癌症或肺癌）相关。VTE发生率从2015年到2023年有所增加。鉴于VTE与更高的治疗强度和更差的预后相关，这一点值得关注，并且在决策过程中应予以考虑。
