Aiham Qdaisat1, Weixin Wu2, Jun-Zhong Lin3, Rawan Al Soud4, Zhi Yang5, Zhihuang Hu6, Shujun Gao7, Carol C Wu8, Xiangdong Liu9, Julio Silvestre1, A Guido Hita1, Jayne Viets-Upchurch1, Saif Al Adwan10, Nafi' Al Haj Qasem10, Maria T Cruz Carreras1, Kalen L Jacobson1, Patrick S Chaftari1, Hikmat Abdel-Razeq10, Cielito C Reyes-Gibby11, Sai-Ching Jim Yeung12. 1. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Oncology, Zhong Shan Hospital, Xiamen Medical University, Xiamen, People's Republic of China. 3. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 4. Department of Emergency Medicine, King Hussein Cancer Center, Amman, Jordan; Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan. 5. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Intensive Care, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China. 6. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. 7. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Center of Diagnosis and Treatment of Cervical Disease, Obstetrics and Gynecology Hospital of Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China. 8. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 9. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Laboratory Medicine, Qilu Hospital, Qilu Medical University, Jinan, Shandong, People's Republic of China. 10. Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan. 11. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 12. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: The accurate detection of cancer-associated venous thromboembolism (VTE) can avoid unnecessary diagnostic imaging or laboratory tests. OBJECTIVE: We sought to determine clinical and cancer-related risk factors of VTE that can be used as predictors for oncology patients presenting to the emergency department (ED) with suspected VTE. METHODS: We retrospectively analyzed all consecutive patients who presented with suspicion of VTE to The University of Texas MD Anderson Cancer Center ED between January 1, 2009, and January 1, 2013. Logistic regression models were used to identify risk factors that were associated with VTE. The ability of these factors to predict VTE was externally validated using a second cohort of patients who presented to King Hussein Cancer Center ED between January 1, 2009, and January 1, 2016. RESULTS: Cancer-related covariates associated with the occurrence of VTE were high-risk cancer type (odds ratio [OR] 3.64 [95% confidence interval {CI} 2.37-5.60], p < 0.001), presentation within 6 months of the cancer diagnosis (OR 1.92 [95% CI 1.62-2.28], p < 0.001), active cancer (OR 1.35 [95% CI 1.10-1.65], p = 0.003), advanced stage (OR 1.40 [95% CI 1.01-1.94], p = 0.044), and the presence of brain metastasis (OR 1.73 [95% CI 1.32-2.27], p < 0.001). When combined, these factors along with other clinical factors showed high prediction performance for VTE in the external validation cohort. CONCLUSIONS: Cancer risk group, presentation within 6 months of cancer diagnosis, active and advanced cancer, and the presence of brain metastases along with other related clinical factors can be used to predict VTE in patients with cancer presenting to the ED.
BACKGROUND: The accurate detection of cancer-associated venous thromboembolism (VTE) can avoid unnecessary diagnostic imaging or laboratory tests. OBJECTIVE: We sought to determine clinical and cancer-related risk factors of VTE that can be used as predictors for oncology patients presenting to the emergency department (ED) with suspected VTE. METHODS: We retrospectively analyzed all consecutive patients who presented with suspicion of VTE to The University of Texas MD Anderson Cancer Center ED between January 1, 2009, and January 1, 2013. Logistic regression models were used to identify risk factors that were associated with VTE. The ability of these factors to predict VTE was externally validated using a second cohort of patients who presented to King Hussein Cancer Center ED between January 1, 2009, and January 1, 2016. RESULTS:Cancer-related covariates associated with the occurrence of VTE were high-risk cancer type (odds ratio [OR] 3.64 [95% confidence interval {CI} 2.37-5.60], p < 0.001), presentation within 6 months of the cancer diagnosis (OR 1.92 [95% CI 1.62-2.28], p < 0.001), active cancer (OR 1.35 [95% CI 1.10-1.65], p = 0.003), advanced stage (OR 1.40 [95% CI 1.01-1.94], p = 0.044), and the presence of brain metastasis (OR 1.73 [95% CI 1.32-2.27], p < 0.001). When combined, these factors along with other clinical factors showed high prediction performance for VTE in the external validation cohort. CONCLUSIONS:Cancer risk group, presentation within 6 months of cancer diagnosis, active and advanced cancer, and the presence of brain metastases along with other related clinical factors can be used to predict VTE in patients with cancer presenting to the ED.
Authors: Mohamad Hemu; Caleb J Chiang; Parva K Bhatt; Aamir Ahmed; Kyaw Zaw Hein; Talal Mourad; Megan E Randall; Andres P Palomo; Jason B Kramer; Ibtihaj Fughhi; Louis Fogg; Philip Bonomi; Tochukwu M Okwuosa Journal: J Thorac Dis Date: 2021-08 Impact factor: 2.895
Authors: Demis N Lipe; Aiham Qdaisat; Eva Rajha; Aisha Al-Breiki; Maria T Cruz Carreras; Patrick Chaftari; Sai-Ching J Yeung; Terry W Rice Journal: Res Pract Thromb Haemost Date: 2022-08-19