In a previously reported study we compared the use of a low-molecular-weight heparin (LMWH) and conventional heparin in the thromboprophylaxis of patients with hip fracture. In an attempt to establish additional factors which could aid in predicting the development of deep-venous thrombosis (DVT), we retrospectively studied several clinical and laboratory variables and found that granulocyte count on admission was higher in patients without subsequent postoperative DVT. Forty additional patients were included in a further prospective study in order to validate our previous findings. 38% of patients who developed DVT had a granulocyte count lower than 9,500/μl, whereas only 18% of those patients with DVT had a count higher than 9,500/μl. These figures imply a positive predictive value of 38 % and a negative predictive value of 82%. We suggest that granulocytes could play a role in the development of DVT and preoperative granulocyte count may be used to detect a high-risk population for DVT after a hip fracture.
Purpose Both venous and arterial thrombotic events (VTE/AT) can be associated with immune checkpoint inhibitors (ICI). However, there is a paucity of information apropos patients in routine clinical practice. Methods/patients Retrospective, multicenter study promoted by the Thrombosis and Cancer Section of the Spanish Society of Medical Oncology (SEOM). Individuals with kidney or bladder cancer who initiated ICI between 01/01/2015 and 12/31/2020 were recruited. Minimum follow-up was 6 months (except in cases of demise). The primary objective was to calculate the incidence of ICI-associated VTE/AT and secondary objectives included to analyze their impact on survival and identify variables predictive of VTE/AT. Results 210 patients with kidney cancer were enrolled. The incidence of VTE/AT during follow-up (median 13 months) was 5.7%. Median overall survival (OS) was relatively lower among subjects with VTE/AT (16 months, 95% CI 0.01–34.2 vs. 27 months, 95% CI 22.6–31.4; p = 0.43). Multivariate analysis failed to reveal predictive variables for developing VTE/ AT. 197 patients with bladder were enrolled. There was a 9.1% incidence rate of VTE/AT during follow-up (median 8 months). Median OS was somewhat higher in patients with VTE/AT (28 months, 95% CI 18.4–37.6 vs 25 months, 95% CI 20.7–29.3; p = 0.821). Serum albumin levels < 3.5 g/dl were predictive of VTE/ AT (p < 0.05). Conclusions There appears to be no association between developing VTE/AT and ICI use in patients with renal or bladder cancer. Serum albumin levels are a predictive factor in individuals with bladder cancer.
PurposeCentral venous catheters (CVCs) have become common practice in oncology. Besides their benefits, as an invasive procedure, several complications are associated with them. Catheter associated thrombosis (CAT) is one of the most relevant due to their impact in quality of life and mortality, but the prothrombotic risk factors implied have been poorly assessed. The aim of the study is to evaluate the incidence of upper extremity deep vein thrombosis (UEDVT) associated to catheter use in patients with solid tumors. Secondary endpoints are to describe the population using CVCs and to evaluate potential risk factors of CAT. MethodsPatients diagnosed of solid tumors assisted at a tertiary level hospital between 2016 and 2019, and using CVCs were included.Results455 patients were enrolled. The incidence of CAT was 5.49% (25) in the whole population. 5.05% (23) was associated with PICC while 0.44% (2) was due to PORT use. Among the factors included in the univariate and multivariate regression models, age ≥50 years and PORT use were identified as protective factors related to the development of CAT.ConclusionCVCs remains a safe approach for the delivering of treatments in patients with solid tumors. Age ≤50 and use of PICC are risk factors for developing CAT. Larger prospective studies are needed to identify additional risk factors of CAT.
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