Baseline characteristics and Outcomes in Patients with Venous Thromboembolism and Active Lung Cancer – a Nationwide Cohort Study in France

Abstract

<b>Background:</b> Active lung cancer is a major risk factor for venous thromboembolism (VTE), associated with poor outcomes. Until recently, the gold standard for VTE and active cancer was low molecular weight heparin (LMWH) <b>Aims:</b> To describe patient characteristics and outcomes among patients with VTE and active lung cancer in France, treated with LMWH <b>Methods:</b> A nationwide retrospective cohort study of all adult patients (identified via the French national health data system) with active lung cancer and VTE prescribed LMWH treatment from 2013 to 2018. Active cancer was defined by the presence of medical claims for cancer diagnosis or cancer-specific treatment in the 6 months prior or 30 days after index VTE event. Rates of bleeding (defined as principal diagnoses of hospital stays), recurrent VTE, and all-cause mortality were assessed at 6 months <b>Results:</b> Among 7899 patients with active lung cancer and VTE treated with LMWH, 6749 (85.44%) had metastasis. Mean Charlson index was 7.41 (3.03); anaemia (1991, 25.21%) and history of bleeding (836, 10.58%) were frequent. At 6 months, overall mortality was very high: 3475 (43.99%). VTE recurrence was diagnosed in 411 (5.2%) patients, giving a crude rate of VTE recurrence at 15.04 [13.75;16.44] per 100 patient-years. Overall bleeding led to hospitalization in 242 (3.06%) patients, corresponding to a crude rate at 8.85 [7.85; 9.99] per 100 patients-years <b>Conclusions:</b> In lung cancer patients with acute VTE and treated with LMWH, most had metastatic disease. During the first 6 months of follow-up, mortality was very high, and patients experienced high rates of VTE recurrence despite LMWH therapy