Cardiovascular Diseases And Psychiatric Disorders During The Diagnostic Workup Of Suspected Hematological Malignancy

• Published in: Clinical epidemiology 2019-01, Vol.11, p.1025-1034
• Main Authors: Liu, Qianwei, Andersson, Therese Ml, Jöud, Anna, Shen, Qing, Schelin, Maria Ec, Magnusson, Patrik Ke, Smedby, Karin E, Fang, Fang
• Format: Article
• Language: English
• Subjects: Biopsy; Bone marrow; Cancer; Cardiac and Cardiovascular Systems; Cardiovascular disease; Cardiovascular diseases; Clinical Medicine; Comorbidity; Diagnostic tests; diagnostic workup; Embolism; Epidemiology; Health risk assessment; hematological malignancy; Hematology; Kardiologi; Klinisk medicin; Leukemia; Lymph node biopsy; Lymphatic system; Lymphoma; Medical and Health Sciences; Medical diagnosis; Medicin och hälsovetenskap; Mental disorders; Multiple myeloma; Original Research; Patients; psychiatric disorders; Surveillance; Thrombosis; Tumors
• ISSN: 1179-1349; 1179-1349
• DOI: 10.2147/clep.s218063

Little attention has been given to the risk of cardiovascular and psychiatric comorbidities during the clinical evaluation of a suspected hematological malignancy. Based on Skåne Healthcare Register, we performed a population-based cohort study of 1,527,449 individuals residing during 2005-2014 in Skåne, Sweden. We calculated the incidence rate ratios (IRRs) of cardiovascular diseases or psychiatric disorders during the diagnostic workup of 5495 patients with hematological malignancy and 18,906 individuals that underwent a bone marrow aspiration or biopsy or lymph node biopsy without receiving a diagnosis of any malignancy ("biopsied individuals"), compared to individuals without such experience (i.e., reference). There was a higher rate of cardiovascular diseases during the diagnostic workup of patients with hematological malignancy (overall IRR, 3.3; 95% CI, 2.9 to 3.8; greatest IRR for embolism and thrombosis, 8.1; 95% CI, 5.2 to 12.8) and biopsied individuals (overall IRR, 4.9; 95% CI, 4.6 to 5.3; greatest IRR for stroke, 37.5; 95% CI, 34.1 to 41.2), compared to reference. Similarly, there was a higher rate of psychiatric disorders during the diagnostic workup of patients with hematological malignancy (IRR, 2.1; 95% CI, 1.5 to 2.8) and biopsied individuals (IRR, 3.1; 95% CI, 2.9 to 3.4). The rate increases were greater around the time of diagnosis or biopsy, compared to thereafter, for both outcomes. There were higher rates of cardiovascular diseases and psychiatric disorders during the diagnostic workup of a suspected hematological malignancy, regardless of the final diagnosis.