Clinical research study
Incidence of Venous Thromboembolism in Patients Hospitalized with Cancer

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Abstract

Background

There are sparse data on the frequency of venous thromboembolism in patients with various types of cancer. We sought to determine the incidence and relative risk of venous thromboembolism, pulmonary embolism, and deep venous thrombosis in patients with malignancies.

Subjects and methods

The number of patients discharged with a diagnostic code for 19 types of malignancies, pulmonary embolism or deep venous thrombosis from 1979 through 1999 was obtained from the National Hospital Discharge Survey. Patients studied were men and women of all ages and races.

Results

In patients with any of the 19 malignancies studied, 827 000 of 40 787 000 (2.0%) had venous thromboembolism, which was twice the incidence in patients without these malignancies, 6 854 000 of 662 309 000 (1.0 %). The highest incidence of venous thromboembolism was in patients with carcinoma of the pancreas, 51 000 of 1 176 000 (4.3%), and the lowest incidences were in patients with carcinoma of the bladder and carcinoma of the lip, oral cavity or pharynx. The overall incidences of pulmonary embolism and deep venous thrombosis were also twice the rates in noncancer patients. Incidences with cancer were not age dependent. The incidence of venous thromboembolism in patients with cancer began to increase in the late 1980s.

Conclusion

Patients with cancer had twice the incidence of venous thromboembolism, pulmonary embolism and deep venous thrombosis as patients without cancer. The incidence of venous thromboembolism, pulmonary embolism and deep venous thrombosis associated with cancer differed according to the type of cancer, was comparable in elderly and younger patients, and increased in the late 1980s and 1990s.

Section snippets

Data Sources

The number of patients discharged from hospitals with a diagnostic code of various malignancies, pulmonary embolism or deep venous thrombosis from 1979 through 1999 was obtained from the National Hospital Discharge Survey.16 The National Hospital Discharge Survey is based on data abstracted from a national probability sample of discharges from short-stay nonfederal hospitals.16 The National Hospital Discharge Survey from 1979 through 1999 consists of data obtained annually from 181 000 to 307 000

Results

Among patients hospitalized from 1979 through 1999, with any of the 19 categories of malignancies evaluated, 827 000 of 40 787 000 (2.0%) had venous thromboembolism, which was twice the incidence of venous thromboembolism in hospitalized patients who did not have any of these malignancies, 6 854 000 of 662 309 000 (1.0 %). The highest incidence of venous thromboembolism was in patients with carcinoma of the pancreas, 51 000 of 1 176 000 (4.3%) (Table 1). The lowest incidence of venous thromboembolism

Discussion

Among patients hospitalized with cancer in short-stay hospitals in the United States, we report venous thromboembolism in 2.0% and pulmonary embolism in 0.6%. The incidence of venous thromboembolism, pulmonary embolism, and deep venous thrombosis in patients hospitalized with various malignancies was double the rate observed in hospitalized patients who did not have any of these malignancies. The rate of venous thromboembolism varied with various malignancies from 4.3% in patients with

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