Frecuencia de tromboembolismo venoso en pacientes hospitalizados con cáncer: factores de riesgo y eficacia de la tromboprofilaxis farmacológica / Frequency of venous thromboembolism among hospitalized patients with cancer

ABSTRACT

Background: Hospitalized patients with cancer have a high risk of venous thromboembolism (VTE). Aim: To study the frequency of VTE and its risk factors in hospitalized patients with cancer. Material and methods: Retrospective analysis of clinical records of patients with cancer, hospitalized at a university hospital between 2002 and 2004. Patients with the diagnosis of VTE at admission or using anticoagulants, were excluded from the analysis. Results: The medical records of 366 patients were reviewed. Fifty three percent had a digestive cáncer, 19 percent lung cáncer, 10 percent breast cancer and 18 percent had a tumor of other origin. In 77 percent, the tumor was in an advanced stage. The most common admission diagnoses were pneumonía, vomiting and dehydration, gastrointestinal bleeding and urinary infection. In 125 patients (34 percent) pharmacological thrombo-prophylaxis was not used and 242 (66 percent) received regular or low molecular weight heparin. VTE was detected in 11 patients (3 percent) and was significantly more common among patients not receiving thrombo prophylaxis compared to those receiving heparin (6.4 percent and 1.2 percent, respectively p =0.014). Factors associated to VTE were a history ofprevious VTE with an odds ratio (OR) of 12.9 (p <0.01), obesity with an OR of 13.3 (p <0.01), recent chemotherapy with an OR of 6.9 (p =0.01). The use of pharmacological thromboprophylaxis had an OR of 0.24 (p =0.05). Conclusions: Three percent of patients in this series had VTE during the hospitalization. Pharmacological thrombo-prophylaxis significantly reduced the risk of VTE.