Anand Narayan1, Kelvin Hong, Michael Streiff, Russell Shinohara, Constantine Frangakis, Josef Coresh, Hyun S Kim. 1. Departments of *Radiology †Medicine, Johns Hopkins School of Medicine §Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD ‡Department of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia ∥Department of Radiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
Abstract
OBJECTIVES: Inferior vena cava (IVC) filters are placed to prevent pulmonary embolism, however, some studies have suggested that IVC filters are associated with exacerbated risks of deep vein/IVC thrombosis in cancer patients. The purpose of this study is to determine if cancer patients develop higher than expected rates of venous thromboembolism complications after filter placement compared with noncancer patients. MATERIALS AND METHODS: A retrospective cohort study of consecutive patients who received filters (2002 to 2006) at Johns Hopkins was conducted. Exposures and outcomes were obtained by chart review. Relative risks (RR, 95% confidence interval [CI]) for outcomes in cancer versus noncancer patients were estimated using multistate models. RESULTS: The cohort included 702 patients-246 with cancer and 456 without cancer. Cancer patients were older, more likely to be white and have filters placed for contraindications to anticoagulation (P<0.01). The most common cancers were lung (11.8%) and colorectal (10.6%). Cancer patients had an increase in venous thromboembolism (RR 1.9 [95% CI, 1.1, 3.2]) due to more deep venous thrombosis/IVC thrombosis (RR 1.7 [95% CI, 1.0, 3.0]). Higher pulmonary embolism rates in cancer were not statistically significant (RR 2.2 [95% CI, 0.8, 5.8]). CONCLUSIONS: Cancer patients have elevated risks of thrombotic complications compared with noncancer patients; however, these risks are not higher than expected based on historical controls.
OBJECTIVES: Inferior vena cava (IVC) filters are placed to prevent pulmonary embolism, however, some studies have suggested that IVC filters are associated with exacerbated risks of deep vein/IVC thrombosis in cancerpatients. The purpose of this study is to determine if cancerpatients develop higher than expected rates of venous thromboembolism complications after filter placement compared with noncancer patients. MATERIALS AND METHODS: A retrospective cohort study of consecutive patients who received filters (2002 to 2006) at Johns Hopkins was conducted. Exposures and outcomes were obtained by chart review. Relative risks (RR, 95% confidence interval [CI]) for outcomes in cancer versus noncancer patients were estimated using multistate models. RESULTS: The cohort included 702 patients-246 with cancer and 456 without cancer. Cancerpatients were older, more likely to be white and have filters placed for contraindications to anticoagulation (P<0.01). The most common cancers were lung (11.8%) and colorectal (10.6%). Cancerpatients had an increase in venous thromboembolism (RR 1.9 [95% CI, 1.1, 3.2]) due to more deep venous thrombosis/IVC thrombosis (RR 1.7 [95% CI, 1.0, 3.0]). Higher pulmonary embolism rates in cancer were not statistically significant (RR 2.2 [95% CI, 0.8, 5.8]). CONCLUSIONS:Cancerpatients have elevated risks of thrombotic complications compared with noncancer patients; however, these risks are not higher than expected based on historical controls.
Authors: John A Kaufman; Thomas B Kinney; Michael B Streiff; Ronald F Sing; Mary C Proctor; Daniel Becker; Mark Cipolle; Anthony J Comerota; Steven F Millward; Frederick B Rogers; David Sacks; Anthony C Venbrux Journal: J Vasc Interv Radiol Date: 2006-03 Impact factor: 3.464
Authors: H Decousus; A Leizorovicz; F Parent; Y Page; B Tardy; P Girard; S Laporte; R Faivre; B Charbonnier; F G Barral; Y Huet; G Simonneau Journal: N Engl J Med Date: 1998-02-12 Impact factor: 91.245
Authors: Hyun S Kim; Mark J Young; Anand K Narayan; Kelvin Hong; Robert P Liddell; Michael B Streiff Journal: J Vasc Interv Radiol Date: 2008-03 Impact factor: 3.464
Authors: Paolo Prandoni; Anthonie W A Lensing; Andrea Piccioli; Enrico Bernardi; Paolo Simioni; Bruno Girolami; Antonio Marchiori; Paola Sabbion; Martin H Prins; Franco Noventa; Antonio Girolami Journal: Blood Date: 2002-07-12 Impact factor: 22.113