From U Rochester: Venous thromboembolism and lung cancer

http://www.ncbi.nlm.nih.gov/pubmed/23026639

Lung Cancer. 2012 Sep 28. pii: S0169-5002(12)00536-3. doi: 10.1016/j.lungcan.2012.09.007. [Epub ahead of print]

Incidence and predictors of venous thromboembolism (VTE) among ambulatory patients with lung cancer.

Connolly GC, Dalal M, Lin J, Khorana AA.

Source

Department of Hematology and Oncology, University of Rochester, Rochester, NY, USA. Electronic address: gregory_connolly@urmc.rochester.edu.

Abstract

BACKGROUND:

The incidence and economic impact of lung cancer-associated venous thromboembolic (VTE) events in a contemporary ambulatory setting is unknown.

PATIENTS AND METHODS:

We conducted a retrospective cohort analysis utilizing the IMS Patient-Centric database of US healthcare claims and recorded VTE events occurring 3-12 months after chemotherapy initiation.

RESULTS:

Lung cancer (n=6732) and control (n=17 284) cohorts had 51% women, with a mean age of 64 years. VTE occurred in 13.9% of the lung cancer cohort (odds ratio [OR], 3.15; 95% confidence interval [CI] 2.55, 3.89), and 1.4% of the control cohort (P<0.0001). Charlson Comorbidity Index ≥5 (CCI; OR, 2.56; 95% CI 1.02, 6.39; P=0.045), the use of erythropoiesis-stimulating agents (ESAs; OR, 1.63; 95% CI 1.40, 1.89; P<0.0001), and congestive heart failure (CHF; OR, 1.29; 95% CI 1.01, 1.66; P=0.045) were associated with VTE. Bleeding occurred in 22.1% of the lung cancercohort and 7.0% of the control cohort (P<0.0001). Among lung cancer patients the average total healthcare payment was $84,187 in patients with VTE compared to $56,818 in patients without VTE (P<0.0001).

CONCLUSIONS:

VTE is common among lung cancer patients receiving chemotherapy and is associated with increased healthcare utilization.