암환자의 정맥혈전색전증 발생 위험요인
Risk Factors Associated with Venous Thromboembolism in Cancer Patients
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Purpose: This study aimed to investigate clinical characteristics of venous thromboembolism (VTE) in cancer patients. Methods: We retrospectively analyzed clinical characteristics in patients with VTE confirmed with cancer. Multivariable logistic regression was used to identify differences associated with the development, between the pulmonary embolism (PE) and deep vein thrombosis (DVT) groups. Results: From January 2009 to December 2014, a total of 103 patients with VTE were included in the final analysis: mean age, 70.6±11.8 years; female, 56.3%. Most of the patients had a solid cancer (95.1%), and half of all patients had distant metastasis (50.5%). Proportion of patients with VTE who received chemotherapy within a year was 64.1%. Central venous catheters were applied to 59 patients within 6 weeks before the diagnosis of VTE. The proportion of patients with DVT only among VTE patients was 21.4%. In logistic regression analysis, central venous catheter insertion (OR=2.66, 95% CI=1.09, 6.49; p=.032), as well as lung metastasis (OR=2.94; 95% CI=1.06, 8.18; p=.039) were significant predictors for PE rather than DVT only. Conclusion: VTE developed in patients with advanced stage cancer. Further studies analyzing the effects of prophylactic anticoagulation in patients with cancer in regards to development of VTE are recommended.
Abstract
Purpose: This study aimed to investigate clinical characteristics of venous thromboembolism (VTE) in cancer patients. Methods: We retrospectively analyzed clinical characteristics in patients with VTE confirmed with cancer. Multivariable logistic regression was used to identify differences associated with the development, between the pulmonary embolism (PE) and deep vein thrombosis (DVT) groups. Results: From January 2009 to December 2014, a total of 103 patients with VTE were included in the final analysis: mean age, 70.6±11.8 years; female, 56.3%. Most of the patients had a solid cancer (95.1%), and half of all patients had distant metastasis (50.5%). Proportion of patients with VTE who received chemotherapy within a year was 64.1%. Central venous catheters were applied to 59 patients within 6 weeks before the diagnosis of VTE. The proportion of patients with DVT only among VTE patients was 21.4%. In logistic regression analysis, central venous catheter insertion (OR=2.66, 95% CI=1.09, 6.49; p=.032), as well as lung metastasis (OR=2.94; 95% CI=1.06, 8.18; p=.039) were significant predictors for PE rather than DVT only. Conclusion: VTE developed in patients with advanced stage cancer. Further studies analyzing the effects of prophylactic anticoagulation in patients with cancer in regards to development of VTE are recommended.
참고문헌 (27)
- Khorana A, "Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy", J Thromb Haemost, 5(3), pp.632~634 (2007)
- Goldhaber SZ, "A prospective registry of 5, 451 patients with ultrasound-confirmed deep vein thrombosis", Am J Cardiol, 93(2), pp.259~262 (2004)
- 방수미, "암 환자에서 발생하는 정맥 혈전색전증의 진단과 치료", 대한내과학회지, 85(5), pp.481~484 (2013), 대한내과학회[DOI]
- 박윤수, "고관절 수술 환자에서 정맥혈전색전증의 예방", Hip and Pelvis, 26(1), pp.1~6 (2014), 대한고관절학회[DOI]
- Bhagya RB, "Venous thromboembolism in cancer patients undergoing major abdominal surgery:prevention and management", ISRN Vascular Medicine, 2012, pp.1~22 (2012)
- Heit JA, "Risk factors for deep vein thrombosis and pulmonary embolism : a population-based case-control study", Arch Intern Med, 160(6), pp.809~815 (2000)
- Song KY, "Prevention and treatment of venous thromboembolism in cancer patients", Korean J Clin Oncol, 5(2), pp.32~40 (2009)
- Chew HK, "Incidence of venous thromboembolism and its effect on survival among patients with common cancers", Arch Intern Med, 166(4), pp.458~464 (2006)
- Choi S, "Different characteristics and prognostic impact of deep-vein thrombosis", pulmonary embolism and intraabdominal venous thrombosis in colorectal cancer patients, 2011, pp.106(6), 1084~1094
- Jang M, "Incidence of venous thromboembolism in Korea : from the Health Insurance Review and Assessment Service database", J Thromb Haemost, 9(1), pp.85~91 (2011)
- Morrison R, "Venous thromboembolism : scope of the problem and the nurse’s role in risk assessment and prevention", J Vasc Nurs, 24(3), pp.82~90 (2006)
- Heit JA, "Predictors of survival after deep vein thrombosis and pulmonary embolism : a population-based, cohort study", Arch Intern Med, 159(5), pp.445~453 (1999)
- 이지은, "Clinical Characteristics of Pulmonary Embolism with Underlying Malignancy", The Korean Journal of Internal Medicine, 25(1), pp.66~70 (2010), 대한내과학회
- Sørensen J, "Performance status assessment in cancer patients. An inter-observer variability study", Br J Cancer, 67(4), pp.773~775 (1993)
- Otten MM, "Symptomatic venous thromboembolism in cancer patients treated with chemotherapy : an underestimated phenomenon", Arch Intern Med, 164(2), pp.190~194 (2004)
- Mousa SA, "Anti-cancer properties of low-molecular-weight heparin : preclinical evidence", Thromb Haemost, 102(2), pp.258~267 (2009)
- Levine MN, "The thrombogenic effect of anticancer drug therapy in women with stage II breast cancer", N Engl J Med, 318(7), pp.404~407 (1988)
- Blom JW, "Malignancies, prothrombotic mutations, and the risk of venous thrombosis", JAMA, 293(6), pp.715~722 (2005)
- Anthony M, "Nursing assessment of deep vein thrombosis", Medsurg Nurs, 22(2), pp.95~98 (2013)
- 김정숙, "하지압박요법이 중증 뇌손상 환자의 대퇴 정맥 혈류 속도변화에 미치는 영향", Journal of Korean Academy of Nursing, 39(2), pp.288~297 (2009), 한국간호과학회
- Broviac J, "A silicone rubber atrial catheter for prolonged parenteral alimentation", Surg Gynecol Obstet, 136(4), pp.602~606 (1973)
- Verso M, "Venous thromboembolism associated with longterm use of central venous catheters in cancer patients", J Clin Oncol, 21(19), pp.3665~3675 (2003)
- Lee AY, "Incidence, risk factors, and outcomes of catheter related thrombosis in adlut patients with cancer", J Clin Oncol, 24(9), pp.1404~1408 (2006)
- De Cicco M, "Central venous thrombosis: an early and frequent complication in cancer patients bearing long-term silastic catheter. A prospective study", Thromb Res, 86(2), pp.101~113 (1997)
- Luciani A, "Catheter-related upper extremity deep venous thrombosis in cancer patients : a prospective study based on Doppler US 1", Radiology, 220(3), pp.655~660 (2001)
- Hutten BA, "Incidence of recurrent thromboembolic and bleeding complications among patients with venous thromboembolism irelation to both malignancy and achieved international normalized ratio : a retrospective analysis", J Clin Oncol, 18(17), pp.3078~3083 (2000)
- Kuter DJ, "Thrombotic complications of central venous catheters in cancer patients", The Oncologist, 9(2), pp.207~216 (2004)