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Title

Lack of prophylaxis before the onset of acute venous thromboembolism among hospitalized cancer patients: the SWIss Venous ThromboEmbolism Registry (SWIVTER)

Authors
Kucher, N.
Spirk, D.
Baumgartner, I.
Mazzolai, L.
Korte, W.
Nobel, D.
Banyai, M.
Published in Annals of Oncology. 2010, vol. 21, no. 5, p. 931-935
Abstract BACKGROUND: Venous thromboembolism (VTE) prophylaxis remains underutilized, particularly in cancer patients. We explored clinical predictors of prophylaxis in hospitalized cancer patients before the onset of acute VTE. METHODS: In the SWiss Venous ThromboEmbolism Registry, 257 cancer patients (61 +/- 15 years) with acute VTE and prior hospitalization for acute medical illness or surgery within 30 days (91% were at high risk with Geneva VTE risk score ≥ 3) were enrolled. RESULTS: Overall, 153 (60%) patients received prophylaxis (49% pharmacological and 21% mechanical) before the onset of acute VTE. Outpatient status at the time of VTE diagnosis [odds ratio (OR) 0.31, 95% confidence interval (CI) 0.18-0.53], ongoing chemotherapy (OR 0.51, 95% CI 0.31-0.85), and recent chemotherapy (OR 0.53, 95% CI 0.32-0.88) were univariately associated with the absence of VTE prophylaxis. In multivariate analysis, intensive care unit admission within 30 days (OR 7.02, 95% CI 2.38-20.64), prior deep vein thrombosis (OR 3.48, 95% CI 2.14-5.64), surgery within 30 days (OR 2.43, 95% CI 1.19-4.99), bed rest >3 days (OR 2.02, 95% CI 1.08-3.78), and outpatient status (OR 0.38, 95% CI 0.19-0.76) remained the only independent predictors of thromboprophylaxis. CONCLUSIONS: Although most hospitalized cancer patients were at high risk, 40% did not receive any prophylaxis before the onset of acute VTE. There is a need to improve thromboprophylaxis in cancer patients, particularly in the presence of recent or ongoing chemotherapy.
Keywords Acute DiseaseAnticoagulants/*therapeutic useAntineoplastic Agents/adverse effectsFemaleHospitalizationHumansMaleMiddle AgedNeoplasms/drug therapyPhysician's Practice Patterns/*statistics & numerical dataPremedication/*utilizationPrognosis*RegistriesVenous Thromboembolism/chemically induced/*prevention & control
Identifiers
PMID: 19828560
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Research groups Geneva Platelet Group (13)
La maladie thromboembolique veineuse (808)
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(ISO format)
KUCHER, N. et al. Lack of prophylaxis before the onset of acute venous thromboembolism among hospitalized cancer patients: the SWIss Venous ThromboEmbolism Registry (SWIVTER). In: Annals of Oncology, 2010, vol. 21, n° 5, p. 931-935. https://archive-ouverte.unige.ch/unige:21055

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Deposited on : 2012-05-23

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