Pattern of Venous Thromboembolism in Gastrointestinal Malignancies

Abstract

Introduction: Venous thromboembolism (VTE) is a known complication of cancer and it is associated with significant morbidity and mortality. There is evidence to show that the risk of VTE depends on the type of cancer along with the stage and type of treatment. As newer therapies are emerging the risk of VTE in gastrointestinal (GI) malignancies is not well known. We want to look at the current trends of VTE with different types of GI malignancies. Methods: We performed a retrospective analysis using the 2013 Healthcare Cost and Utilization Project - National Inpatient Sample (HCUP-NIS). GI malignancy patients were identified by CCS diagnosis code. From these patients we further identified the patients with venous thromboembolism by using ICD-9 diagnosis code. We used SAS survey frequency procedure to examine different types of VTE in different types of GI malignancy patients. Weighted variable discwt in the NIS sample was used to get national estimates. Results: We identified 0.92 million (928669) patients with GI malignancies. Colorectal cancer (572295) was found to be most frequent GI malignancy while esophageal cancer was found to be least frequent. Table 1 summarizes the VTE cases in different types of GI malignancies. Pancreatic, stomach, other GI and esophageal cancer had the leading cases of deep vein thrombosis and pulmonary embolism. Hepatic vein, portal vein and inferior vena cava thrombosis were mostly seen in liver and pancreatic cancer patients.Table 1: GI malignancies and VTEConclusion: VTE pattern varies with the type of GI malignancy. Pancreatic cancer is associated with the highest rates of VTE as well as portal vein and hepatic vein thrombosis. Current observations may help to identify patients with unusual site of thromboembolism in GI malignancies.