Comparative analysis of health disparities in prostate cancer patients with and without venous thromboembolism, and with and without anticoagulation therapy.

Abstract

Listen

Translate article

e17162 Background: Venous thromboembolism (VTE) in cancer is a commonly observed clinical complication. The risk of VTE is high in prostate cancer when compared to men without prostate cancer. Methods: We conducted a retrospective analysis using the 2022 NIS database to examine health disparities in prostate cancer patients with DVT and PE. Patients were categorized into groups based on the presence or absence of DVT, PE, and whether or not they were on anticoagulation, with no prior venous thrombosis. Health disparities, including length of stay, total charges, age, and mortality, were analyzed using chi-square and t-tests, with p<0.05 considered significant. Results: A total number of 163,468 patients were identified with a diagnosis of prostate cancer. Out of this, a total of 10,129 were identified with DVT, 14,420 with PE, and 13,695 patients on anticoagulation with no prior VTE history. Patients with DVT had a higher percentage of mortality (14.28%) compared to those without DVT (8.82%) with chi2= 3556.6, p=0.00. Similarly, prostate cancer patients with PE had a higher percentage of mortality (10.8%) compared to those without PE (8.9%) with chi2= 2549.4(p = 0.00). The mortality rate of patients with and without anticoagulation was 7.1% vs 8.7% (p= 0.00). The mean age of prostate cancer patients who were hospitalized with DVT was 64 years, 65 years in PE, and 70 years in patients with anticoagulation. There was no statistically significant difference in the mean total charges between patients with PE (M = $94,603.37, SD = 130,494.3) and without PE (M = $94,838.35, SD = 129,395) with p=0.84. However, patients with DVT had significantly higher mean total charges during hospitalization (M = $137,298.40, SD = 208,128.1) compared to those without DVT (M = $92,015.77, SD = 122,026.7), with a t (163461) = 34.05, p < 0.00. DVT was associated with increased length of stay (M = 9.6 days, SD = 9.46) compared to without DVT (M = 6.6 days, SD = 7.63) with a t (163461) = 37.67, p < 0.00. PE was associated with prolonged length of stay (M = 7.2 days, SD = 8.2) compared to without PE (M = 6.7 days, SD = 7.8) with t(17,056) = 6.01, p< 0.00. The patients on anticoagulation had lower total charges during hospitalization than those without ($76475.5 vs $94045.5 with p<0.00) and slight variation in their Length of stay (6.1 vs 6.6 days with p<0.00). Conclusions: Venous thromboembolism was significantly associated with higher total charges (except PE), length of stay, and mortality in prostate cancer patients. The anticoagulated patients were noted to have low mortality rates, total hospitalization charges, and length of stay. Therefore, preventing venous thromboembolism may decrease healthcare utilization and mortality in these patient populations. This analysis suggests that prophylactic anticoagulation in these patients may be an area of future research.