Clinical characteristics and prognosis of elderly patients with malignant tumors complicated with venous thromboembolism / 中华老年医学杂志

ABSTRACT

Objective:To analyze the clinical features and prognosis of elderly patients with malignant tumors complicated with venous thromboembolism(VTE).Methods:The clinical data of 280 patients with malignant tumors and VTE hospitalized in Beijing Hospital from January 2003 to January 2013 were retrospectively analyzed.The clinical features and prognosis were analyzed and compared between the elderly and non-elderly groups.Results:Of the 280 patients with VTE, 167(59.6%)were elderly and 113(40.4%)were non-elderly, with an average age of(75.2±6.1)years and(53.9±8.2)years, respectively.Patients in the elderly group were associated with higher incidences of hypertension, coronary heart disease, cardiac insufficiency and chronic obstructive pulmonary disease, lower rate of liver disease, higher proportions of urinary system tumors, braking for more than 3 d, trauma history and surgery history(>3 months), lower proportions of chemotherapy history and surgery history(<1 month), increased occurrences of fever and lower extremity edema( χ2=6.043, P=0.014; χ2=3.862, P=0.049), a higher score of pulmonary embolism severity index( t=3.339, P=0.001), a lower platelet level in the elderly group( Z=-2.383, P=0.017), and a higher D-dimer level( Z=-3.150, P=0.002)compared with those in the non-elderly group(all P<0.05). Up to the follow-up time, 89 elderly patients in the elderly group died, with an average survival time of (29.3±2.8)months.However, 41 patients died in the non-elderly group with an average survival time of (49.7±4.1)months.The proportion of death in the elderly group(89/167, 53.3%)was higher than that in the non-elderly group(41/113, 36.3%)( χ2=8.394, P=0.004). Log-rank test showed that the difference in survival time between the two groups was statistically significant( χ2=8.878, P=0.003). The binary Logistic regression analysis showed that elderly men(≥65 years)( OR=3.263, 95% CI 1.600~6.654)and urinary system tumors( OR=4.875, 95% CI 1.526~15.571)were predictive factors of death in the elderly with malignant tumor and VTE. Conclusions:Patients with malignant tumors and VTE are more common in elderly patients.Elder patients have more comorbidities, greater disease severity and a higher rate of mortality.And male and urinary system tumors are predictors of death in elderly patients.