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PURPOSEPatients with isolated distal deep vein thrombosis (DVT) have lower rates of adverse outcomes (death, venous thromboembolism [VTE] recurrence or major bleeding) than those with proximal DVT. It is uncertain if such findings are also observed in patients with cancer.METHODSUsing data from the international Registro Informatizado de la Enfermedad TromboEmbolica venosa registry, we compared the risks of adverse outcomes at 90 days (adjusted odds ratio [aOR]; 95% CI) and 1 year (adjusted hazard ratio [aHR; 95% CI]) in 886 patients with cancer-associated distal DVT versus 5,196 patients with cancer-associated proximal DVT and 5,974 patients with non-cancer-associated distal DVT.RESULTSMore than 90% of patients in each group were treated with anticoagulants for at least 90 days. At 90 days, the adjusted risks of death, VTE recurrence, or major bleeding were lower in patients with non-cancer-associated distal DVT than in patients with cancer-associated distal DVT (reference): aOR = 0.16 (0.11-0.22), aOR = 0.34 (0.22-0.54), and aOR = 0.47 (0.27-0.80), respectively. The results were similar at 1-year follow-up: aHR = 0.12 (0.09-0.15), aHR = 0.39 (0.28-0.55), and aHR = 0.51 (0.32-0.82), respectively. Risks of death, VTE recurrence, and major bleeding were not statistically different between patients with cancer-associated proximal versus distal DVT, both at 90 days: aOR = 1.11 (0.91-1.36), aOR = 1.10 (0.76-1.62), and aOR = 1.18 (0.76-1.83), respectively, and 1 year: aHR = 1.01 (0.89-1.15), aHR = 1.02 (0.76-1.35), and aHR = 1.10 (0.76-1.61), respectively. However, more patients with cancer-associated proximal DVT, compared with cancer-associated distal DVT, developed fatal pulmonary embolism (PE) during follow-up: The risk difference was 0.40% (95% CI, 0.23 to 0.58).CONCLUSIONCancer-associated distal DVT has serious and relatively comparable outcomes compared with cancer-associated proximal DVT. The lower risk of fatal PE from cancer-associated distal DVT needs further investigation.
Clinical Presentation and Outcomes of Patients with Cancer-Associated Isolated Distal Deep Vein Thrombosis
Galanaud J. -P.;Trujillo-Santos J.;Bikdeli B.;Bertoletti L.;Di Micco P.;Poenou G.;Falga C.;Zdraveska M.;Lima J.;Rivera-Civico F.;Muixi J. F.;Monreal M.;Adarraga M. D.;Alberich-Conesa A.;Agudo P.;Aibar J.;Alfonso J.;Amado C.;Amoros S.;Angelina-Garcia M.;Arcelus J. I.;Ballaz A.;Barba R.;Barbagelata C.;Barron M.;Barron-Andres B.;Bascunana J.;Beddar-Chaib F.;Blanco-Molina A.;Botella E.;Chasco L.;Cerda P.;Criado J.;Toro J. D.;De Ancos C.;Demelo-Rodriguez P.;De Juana-Izquierdo C.;Diaz-Brasero A. M.;Diaz-Pedroche M. D. C.;Diaz-Peromingo J. A.;Dubois-Silva A.;Escribano J. C.;Esposito F.;Falga C.;Farfan-Sedano A. I.;Fernandez-Aracil C.;Fernandez-Capitan C.;Fernandez-Jimenez B.;Fernandez-Muixi J.;Fernandez-Reyes J. L.;Font C.;Francisco I.;Gabara C.;Garcia De Herreros M.;Garcia-Bragado F.;Garcia-Ortega A.;Gavin-Sebastian O.;Gil-De Gomez M.;Gil-Diaz A.;Gomez-Cuervo C.;Gonzalez-Martinez J.;Grau E.;Guirado L.;Gutierrez J.;Hernandez-Blasco L.;Jaras M. J.;Jimenez D.;Jou I.;Joya M. D.;Lago-Rodriguez M. O.;Lainez-Justo S.;Latorre-Diez A.;Lecumberri R.;Leon-Ramirez J. M.;Lima J.;Lobo J. L.;Lopez-De La Fuente M.;Lopez-Jimenez L.;Lopez-Miguel P.;Lopez-Nunez J. J.;Lopez-Reyes R.;Lopez-Ruiz A.;Lopez-Saez J. B.;Lorente M. A.;Lorenzo A.;Lumbierres M.;Madridano O.;Maestre A.;Mas-Maresma L.;Marcos M.;Martin-Guerra J. M.;Martin-Martos F.;Martinez-Redondo I.;Mellado M.;Mena E.;Mercado M. I.;Moises J.;Monreal M.;Munoz-Blanco A.;Munoz-Gamito G.;Navas M. S.;Nieto J. A.;Noguera-Gras E.;Nunez-Fernandez M. J.;Olid-Velilla M.;Ordieres-Ortega L.;Ortiz M.;Osorio J.;Otalora S.;Pacheco-Gomez N.;Paredes-Ruiz D.;Parra P.;Pedrajas J. M.;Perez-Ductor C.;Peris M. L.;Pesce M. L.;Porras J. A.;Poyo-Molina J.;Puchades R.;Riera-Mestre A.;Rivera-Civico F.;Rivera-Gallego A.;Roca M.;Rosa V.;Rodriguez-Cobo A.;Rodriguez-Matute C.;Rubio C. M.;Ruiz-Artacho P.;Ruiz-Gimenez N.;Ruiz-Ruiz J.;Salgueiro G.;Sancho T.;Sendin V.;Siguenza P.;Soler S.;Suarez-Rodriguez B.;Surinach J. M.;Tirado R.;Tolosa C.;Torres M. I.;Trujillo-Santos J.;Uresandi F.;Valle R.;Varona J. F.;Vidal G.;Villares P.;Ay C.;Nopp S.;Pabinger I.;Martens C.;Vanassche T.;Verhamme P.;Bok Yoo H. H.;Arguello J. D.;Montenegro A. C.;Roa J.;Hirmerova J.;Maly R.;Accassat S.;Bertoletti L.;Bura-Riviere A.;Catella J.;Chopard R.;Couturaud F.;Espitia O.;Grange C.;Leclercq B.;Le Mao R.;Mahe I.;Moustafa F.;Plaisance L.;Poenou G.;Sarlon-Bartoli G.;Suchon P.;Versini E.;Schellong S.;Brenner B.;Dally N.;Tzoran I.;Kaviani R.;Moosavi J.;Sadeghipour P.;Basaglia M.;Bilora F.;Bortoluzzi C.;Brandolin B.;Ciammaichella M.;Colaizzo D.;Dentali F F.;Di Micco P.;Giorgi-Pierfranceschi M.;Grandone E.;Imbalzano E.;Merla S.;Pesavento R.;Prandoni P.;Scarinzi P.;Siniscalchi C.;Taflaj B.;Tufano A.;Visona A.;Hong N. V.;Zalunardo B.;Kigitovica D.;Paluga R.;Skride A.;Fonseca S.;Manuel M.;Meireles J.;Pinto S.;Bosevski M.;Lazarova E.;Zdraveska M.;Bounameaux H.;Mazzolai L.;Caprini J. A.;Weinberg I.;Bui H. M.
2024
Abstract
PURPOSEPatients with isolated distal deep vein thrombosis (DVT) have lower rates of adverse outcomes (death, venous thromboembolism [VTE] recurrence or major bleeding) than those with proximal DVT. It is uncertain if such findings are also observed in patients with cancer.METHODSUsing data from the international Registro Informatizado de la Enfermedad TromboEmbolica venosa registry, we compared the risks of adverse outcomes at 90 days (adjusted odds ratio [aOR]; 95% CI) and 1 year (adjusted hazard ratio [aHR; 95% CI]) in 886 patients with cancer-associated distal DVT versus 5,196 patients with cancer-associated proximal DVT and 5,974 patients with non-cancer-associated distal DVT.RESULTSMore than 90% of patients in each group were treated with anticoagulants for at least 90 days. At 90 days, the adjusted risks of death, VTE recurrence, or major bleeding were lower in patients with non-cancer-associated distal DVT than in patients with cancer-associated distal DVT (reference): aOR = 0.16 (0.11-0.22), aOR = 0.34 (0.22-0.54), and aOR = 0.47 (0.27-0.80), respectively. The results were similar at 1-year follow-up: aHR = 0.12 (0.09-0.15), aHR = 0.39 (0.28-0.55), and aHR = 0.51 (0.32-0.82), respectively. Risks of death, VTE recurrence, and major bleeding were not statistically different between patients with cancer-associated proximal versus distal DVT, both at 90 days: aOR = 1.11 (0.91-1.36), aOR = 1.10 (0.76-1.62), and aOR = 1.18 (0.76-1.83), respectively, and 1 year: aHR = 1.01 (0.89-1.15), aHR = 1.02 (0.76-1.35), and aHR = 1.10 (0.76-1.61), respectively. However, more patients with cancer-associated proximal DVT, compared with cancer-associated distal DVT, developed fatal pulmonary embolism (PE) during follow-up: The risk difference was 0.40% (95% CI, 0.23 to 0.58).CONCLUSIONCancer-associated distal DVT has serious and relatively comparable outcomes compared with cancer-associated proximal DVT. The lower risk of fatal PE from cancer-associated distal DVT needs further investigation.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3543155
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
