The Risk Factors of VTE and Survival Prognosis of Patients With Malignant Cancer: Implication for Nursing and Treatment

Abstract

Venous thromboembolism (VTE) is very common in patients with malignant cancer. We aimed to conduct a retrospective analysis on the risk factors of VTE and its survival prognosis of patients with malignant cancer, to provide evidence into the management of VTE. Patients with malignant cancer treated in our hospital were selected. The characteristic of patients and related lab detection results including activated partial thromboplastin time (APTT), plasma prothrombin time (PT) and thrombin coagulation time (TT), fibrinogen (FIB), thrombin AT-Ⅲ complex (TAT) and D-dimer (D-D) were collected and analyzed. And logistic regression analyses were performed to identify the potential risk factors. And ROC curves were established to evaluate their predictive ability of VTE for patients with malignant cancers. A total of 286 patients were included, of which 63 patients had VTE, the incidence of VTE in patients with malignant cancers was 22.03%. There were significant differences on the D-D, TAT level between VTE and no VTE patients (all P < 0.05). The survival condition of VTE patients was significantly worse than that of no VTE patients(P = 0.017). D-D (RR7.895, 3.228∼19.286) and TAT (6.122, 2.244∼16.695) were risk factors of VTE for patients with cancers (all P < 0.05). The area under the curve (AUC) of D-D, TAT and combined use was 0.764, 0.698, 0.794 respectively, and the cutoff value for D-D, TAT was 1.835mg/L and 4.58μg/L respectively. For cancer patients with D-D >1.835 mg/L and TAT >4.58 μg/L, early interventions are needed for the prophylaxis of VTE.

One-year incidence of venous thromboembolism, bleeding, and death in patients with solid tumors newly initiating cancer treatment: Results from the Cancer-VTE Registry

“…For patients with cancer, in addition to coping with the burden of their tumor(s), venous thromboembolism (VTE) may develop as a complication, resulting in a worsened prognosis and increased mortality risk [1,2]. Cancer patients have a 5-fold higher risk of developing VTE than healthy individuals (annual incidence of 0.5% vs. 0.1%) [3].…”

Incidence and risk factors for venous thromboembolism, bleeding, and death in colorectal cancer (Cancer‐VTE Registry)

“…3 For patients with cancer, in addition to coping with the burden of their tumor(s), venous thromboembolism (VTE) may develop as a complication, resulting in a worsened prognosis and increased mortality risk. 4,5 The mechanism by which cancer patients are at increased risk of developing VTE is complex and is thought to involve a combination of factors. 6 It is known that in cancer patients, cancer cells can activate hemostasis through multiple pathways and thereby induce systemic hypercoagulability.…”

“…In 2020, colorectal cancer was the most common malignancy in Japan, affecting >148,500 people and causing >59,000 deaths 3 . For patients with cancer, in addition to coping with the burden of their tumor(s), venous thromboembolism (VTE) may develop as a complication, resulting in a worsened prognosis and increased mortality risk 4,5 …”

“…3 For patients with cancer, in addition to coping with the burden of their tumor(s), venous thromboembolism (VTE) may develop as a complication, resulting in a worsened prognosis and increased mortality risk. 4 , 5 …”

Thrombin Generation Markers as Predictors of Cancer-Associated Venous Thromboembolism: A Systematic Review

“…2). Of these, 11 studies reported data on F1.2 15,19,[25][26][27][28][29][30][31][32][33] (►Table 2), nine studies reported data on TAT [25][26][27]30,[33][34][35][36][37] (►Table 3), and 12 studies reported data Embase ('malignant neoplasm'/exp OR cancer à OR neoplasm à OR malignanc à ) AND ('thromboembolism'/exp OR "venous thromboembolism" OR "venous thrombo-embolism" OR "venous thrombosis" OR "deep vein thromboembolism" OR "deep vein thrombosis" OR "portal thrombosis" OR "sinus thrombosis" OR "mesenterial thrombosis" OR "cerebral vein thrombosis" OR "cancer-associated thrombosis" OR "VTE" OR "DVT") AND ('thrombin'/exp OR 'thrombography'/exp OR "thrombin" OR "calibrated automated thrombogram" OR "thrombography" OR "prothrombin" OR 'thrombin antithrombin complex'/exp OR "TAT" OR "thrombinantithrombin") NOT 'conference abstract'/it on thrombin generation 13,21,28,29,31,[38][39][40][41][42][43][44] (►Table 4). Of the 24 included papers, 13 were rated as good, eight as fair, and three studies were rated as poor.…”