Inpatient chemotherapy and risk for venous thromboembolism

Abstract

9092 Background: Chemotherapy is a known risk factor for venous thromboembolism (VTE) but contemporary rates and risk factors for chemotherapy-associated VTE are not well described. Furthermore, it is linked to increased hospital length of stay and has negative impact on patient quality of life (QOL). Methods: We used discharge codes to identify all patients admitted to the University of Rochester Medical Center in Rochester, NY from January, 2000 through December, 2005 for chemotherapy and conducted a retrospective chart review to identify those that developed VTE. Inclusion criteria consisted of patients with a malignancy, age greater than eighteen years and no prior history of VTE. VTE was defined as any deep venous thrombosis (DVT) or pulmonary embolism (PE) occurring within 4 weeks of receiving inpatient chemotherapy. Results: A total of 659 patients were admitted for inpatient chemotherapy during the study period. Fifty-four patients developed a DVT and 14 patients developed a PE for a total VTE rate of 9.6%. Median time to developing VTE was 12 days (range, 1 to 28 days). Common sites of cancer among patients who developed VTE included lymphoma (36%) followed by leukemia (28%), multiple myeloma (13%) and gastrointestinal malignancies (8%) among others. Fifteen patients (23%) had stage IV disease. Twelve patients (18%) had a pre-chemotherapy platelet count greater than 350,000/mm3, a known risk factor for chemotherapy-associated VTE. Conclusions: VTE is common in patients receiving chemotherapy, including those with hematologic malignancies and can have significant impacts on patient QOL. The risk for VTE extends beyond the period of inpatient hospitalization. Increased efforts to improve compliance with thromboprophylaxis are warranted to reduce the burden of VTE among cancer patients receiving inpatient chemotherapy. No significant financial relationships to disclose.