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

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2012-12, Vol.78 (3), p.253-258
• Main Authors: Connolly, G.C, Dalal, M, Lin, J, Khorana, A.A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ambulatory Care - economics; Ambulatory Care - utilization; Biological and medical sciences; Blood and lymphatic vessels; Cancer-associated thrombosis; Cardiology. Vascular system; Case-Control Studies; Comorbidity; Cost of care; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Health Expenditures; Health resource utilization; Hematology, Oncology and Palliative Medicine; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Hypertension - epidemiology; Incidence; Logistic Models; Lung cancer; Lung Neoplasms - complications; Lung Neoplasms - economics; Lung Neoplasms - epidemiology; Male; Medical sciences; Middle Aged; Multivariate Analysis; Pneumology; Pulmonary embolism; Pulmonary Embolism - economics; Pulmonary Embolism - epidemiology; Pulmonary Embolism - etiology; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Pulmonary/Respiratory; Retrospective Studies; Risk Factors; Tumors; Tumors of the respiratory system and mediastinum; Venous thromboembolism; Venous Thromboembolism - economics; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2012.09.007

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 cancer cohort 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.