Risk Factors for Thromboembolism in the Population of Cancer and Hospice Patients
DOI:
https://doi.org/10.12775/JEHS.2024.72.51119Keywords
Venous Thrombosis, Pulmoonary Embolism,, Venosus Thromboembolism, Sign and Symptoms, Prevention and ControlAbstract
Venous thromboembolism (VTE) is a significant cause of death among palliatively treated patients. So far, numerous studies have been conducted on the general population. As a result, special scales were created to assess the risk of VTE or the probability of its occurrence. Among patients with terminal disease, there are much fewer publications discussing the problem of VTE. Hospice care patients constitute a special group due to their epidemiological structure and accompanying diagnoses. The most common are malignant tumors and heart failure. For this reason, they are particularly vulnerable to VTE events.
This article reviews the literature on risk scales such as The Padua Risk Assessment Scale, Khoran score, Wells scale, PVFS scale and VTE-BLEED scale. W also present risk factors which contribute to the development of the VTE as well as to a more serious course of VTE. We discuss the epidemiological structure of patients, the impact of cancer as well as the chemotherapy used to treat it. We discuss the epidemiological structure of patients, the impact of cancer as well as the chemotherapy used in its treatment. We describe how the presence of a catheter and immobilization contribute to the development of VTE. We focus particularly on scales and risk factors to which a patient with a terminal disease is exposed.
More research is needed in the future to better predict VTE in hospice patients. We hope that this work will increase awareness and encourage researchers to expand knowledge in this area.
References
Bruni-Fitzgerald KR. Venous thromboembolism: An overview. Journal of Vascular Nursing. 2015;33(3). doi:10.1016/j.jvn.2015.02.001
Phillippe HM. Overview of venous thromboembolism. Am J Manag Care. 2017;23(20).
Costa J, Araújo A. Cancer-Related Venous Thromboembolism: From Pathogenesis to Risk Assessment. Semin Thromb Hemost. 2021;47(6). doi:10.1055/s-0040-1718926
Eichinger S. Cancer associated thrombosis: Risk factors and outcomes. Thromb Res. 2016;140. doi:10.1016/S0049-3848(16)30092-5
Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ. Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study. Arch Intern Med. 2002;160(6):809-815. doi:10.1001/archinte.160.6.809
Noble S. The challenges of managing cancer related venous thromboembolism in the palliative care setting. Postgrad Med J. 2007;83(985). doi:10.1136/pgmj.2007.061622
Alhamadh MS, Alanazi RB, Alqirnas MQ, et al. The burden and predictors of venous thromboembolic diseases in patients with multiple primary malignancies. Cancer Rep. 2023;6(3). doi:10.1002/cnr2.1742
Anderson FA, Spencer FA. Risk Factors for Venous Thromboembolism. Circulation. 2003;107(23_suppl_1). doi:10.1161/01.CIR.0000078469.07362.E6
Rogers MAM, Levine DA, Blumberg N, Flanders SA, Chopra V, Langa KM. Triggers of Hospitalization for Venous Thromboembolism. Circulation. 2012;125(17):2092-2099. doi:10.1161/CIRCULATIONAHA.111.084467
BARBAR S, NOVENTA F, ROSSETTO V, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. Journal of Thrombosis and Haemostasis. 2010;8(11):2450-2457. doi:10.1111/j.1538-7836.2010.04044.x
Dutia M, White RH, Wun T. Risk assessment models for cancer-associated venous thromboembolism. Cancer. 2012;118(14):3468-3476. doi:10.1002/CNCR.26597
Lyman GH, Bohlke K, Falanga A. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Oncol Pract. 2015;11(3):e442-e444. doi:10.1200/JOP.2015.004473
van Es N, Franke VF, Middeldorp S, Wilmink JW, Büller HR. The Khorana score for the prediction of venous thromboembolism in patients with pancreatic cancer. Thromb Res. 2017;150:30-32. doi:10.1016/J.THROMRES.2016.12.013
Pelzer U, Sinn M, Stieler J, Riess H. Primäre medikamentöse Thromboembolieprophylaxe bei ambulanten Patienten mit fortgeschrittenem Pankreaskarzinom unter Chemotherapie? DMW - Deutsche Medizinische Wochenschrift. 2013;138(41):2084-2088. doi:10.1055/S-0033-1349608
Antic D, Milic N, Nikolovski S, et al. Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients. Am J Hematol. 2016;91(10):1014-1019. doi:10.1002/AJH.24466
Zabrocka E, Sierko E. Thromboprophylaxis in the End-of-Life Cancer Care: The Update. Cancers (Basel). 2020;12(3):600. doi:10.3390/cancers12030600
Noble S. Venous thromboembolism and palliative care. Clinical Medicine. 2019;19(4):315-318. doi:10.7861/clinmedicine.19-4-315
Johnson MJ, McMillan B, Fairhurst C, et al. Primary thromboprophylaxis in hospices: the association between risk of venous thromboembolism and development of symptoms. J Pain Symptom Manage. 2014;48(1):56-64. doi:10.1016/J.JPAINSYMMAN.2013.08.016
Loosen SH, Krieg S, Eschrich J, et al. The Landscape of Outpatient Palliative Care in Germany: Results from a Retrospective Analysis of 14,792 Patients. Int J Environ Res Public Health. 2022;19(22). doi:10.3390/IJERPH192214885
World Health Organization, Palliative care, World Health Organization (2020). https://www.who.int/news-room/fact-sheets/detail/palliative-care#:~:te xt=Each%20year%2C%20an%20estimated%2040,palliative%20care%20currently %20receive%20it.
Gade IL, Brækkan SK, Næss IA, et al. The impact of initial cancer stage on the incidence of venous thromboembolism: the Scandinavian Thrombosis and Cancer (STAC) Cohort. Journal of Thrombosis and Haemostasis. 2017;15(8):1567-1575. doi:10.1111/jth.13752
A. Trousseau. Clinique Médicale de l’Hôtel-Dieu de Paris / Par A. Trousseau.
Nuttall GAM. Hemostasis and Thrombosis: Basic Principles and Clinical Practice, 5th Ed.
Rak J, Yu JL, Luyendyk J, Mackman N. Oncogenes, Trousseau Syndrome, and Cancer-Related Changes in the Coagulome of Mice and Humans. Cancer Res. 2006;66(22):10643-10646. doi:10.1158/0008-5472.CAN-06-2350
Chew HK, Wun T, Harvey D, Zhou H, White RH. Incidence of Venous Thromboembolism and Its Effect on Survival Among Patients With Common Cancers. Arch Intern Med. 2006;166(4):458. doi:10.1001/archinte.166.4.458
Stein PD, Beemath A, Meyers FA, Skaf E, Sanchez J, Olson RE. Incidence of Venous Thromboembolism in Patients Hospitalized with Cancer. Am J Med. 2006;119(1):60-68. doi:10.1016/j.amjmed.2005.06.058
Kabbinavar F, Hurwitz HI, Fehrenbacher L, et al. Phase II, randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol. 2003;21(1):60-65. doi:10.1200/JCO.2003.10.066
Kuenen BC, Levi M, Meijers JCM, et al. Potential role of platelets in endothelial damage observed during treatment with cisplatin, gemcitabine, and the angiogenesis inhibitor SU5416. J Clin Oncol. 2003;21(11):2192-2198. doi:10.1200/JCO.2003.08.046
Cavo M, Zamagni E, Cellini C, et al. Deep-vein thrombosis in patients with multiple myeloma receiving first-line thalidomide-dexamethasone therapy. Blood. 2002;100(6):2272-2273. doi:10.1182/BLOOD-2002-06-1674
Seng S, Liu Z, Chiu SK, et al. Risk of Venous Thromboembolism in Patients With Cancer Treated With Cisplatin: A Systematic Review and Meta-Analysis. Journal of Clinical Oncology. 2012;30(35):4416-4426. doi:10.1200/JCO.2012.42.4358
Nalluri SR, Chu D, Keresztes R, Zhu X, Wu S. Risk of Venous Thromboembolism With the Angiogenesis Inhibitor Bevacizumab in Cancer Patients. JAMA. 2008;300(19):2277. doi:10.1001/jama.2008.656
Khorana AA, Francis CW, Culakova E, Lyman GH. Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study. Cancer. 2005;104(12):2822-2829. doi:10.1002/cncr.21496
Citla Sridhar D, Abou-Ismail MY, Ahuja SP. Central venous catheter-related thrombosis in children and adults. Thromb Res. 2020;187:103-112. doi:10.1016/j.thromres.2020.01.017
Kucher N. Deep-Vein Thrombosis of the Upper Extremities. New England Journal of Medicine. 2011;364(9):861-869. doi:10.1056/NEJMcp1008740
Wang P, He L, Yuan Q, et al. Risk factors for peripherally inserted central catheter-related venous thrombosis in adult patients with cancer. Thromb J. 2024;22(1):6. doi:10.1186/s12959-023-00574-4
Gregory Y. H. Lip MFCRGM. Does Heart Failure Confer A Hypercoagulable State? Virchow’s Triad Revisited. J Am Coll Cardiol. 1999;33(5):1424-1426. doi:10.1016/S0735-1097(99)00033-9
Sbarouni E, Bradshaw A, Andreotti F, Tuddenham E, Oakley CM, Cleland JGF. Relationship between hemostatic abnormalities and neuroendocrine activity in heart failure. Am Heart J. 1994;127(3):607-612. doi:10.1016/0002-8703(94)90670-X
JAFRI SM, OZAWA T, MAMMEN E, LEVINE TB, JOHNSON C, GOLDSTEIN S. Platelet function, thrombin and fibrinolytic activity in patients with heart failure. Eur Heart J. 1993;14(2):205-212. doi:10.1093/eurheartj/14.2.205
Xu T, Huang Y, Liu Z, et al. Heart Failure Is Associated with Increased Risk of Long-Term Venous Thromboembolism. Korean Circ J. 2021;51(9):766. doi:10.4070/kcj.2021.0213
Ota S, Yamada N, Tsuji A, Ishikura K, Nakamura M, Ito M. Incidence and Clinical Predictors of Deep Vein Thrombosis in Patients Hospitalized With Heart Failure in Japan. Circulation Journal. 2009;73(8):1513-1517. doi:10.1253/circj.CJ-08-0990
BARBAR S, NOVENTA F, ROSSETTO V, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. Journal of Thrombosis and Haemostasis. 2010;8(11):2450-2457. doi:10.1111/j.1538-7836.2010.04044.x
Ostgathe C, Alt-Epping B, Golla H, et al. Non-cancer patients in specialized palliative care in Germany: What are the problems? Palliat Med. 2011;25(2):148-152. doi:10.1177/0269216310385370
Ostgathe C, Gaertner J, Kotterba M, et al. Differential palliative care issues in patients with primary and secondary brain tumours. Supportive Care in Cancer. 2010;18(9):1157-1163. doi:10.1007/s00520-009-0735-y
Geersing GJ, Zuithoff NPA, Kearon C, et al. Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data meta-analysis. BMJ. 2014;348. doi:10.1136/BMJ.G1340
Steiner D, Nopp S, Weber B, et al. The post-VTE functional status scale for assessment of functional limitations in patients with venous thromboembolism: Construct validity and responsiveness in a prospective cohort study. Thromb Res. 2023;221:1-6. doi:10.1016/J.THROMRES.2022.11.006
Klok FA, Hösel V, Clemens A, et al. Prediction of bleeding events in patients with venous thromboembolism on stable anticoagulation treatment. Eur Respir J. 2016;48(5):1369-1376. doi:10.1183/13993003.00280-2016
Badescu M, Ciocoiu M, Badulescu O, et al. Prediction of bleeding events using the VTE-BLEED risk score in patients with venous thromboembolism receiving anticoagulant therapy (Review). Exp Ther Med. 2021;22(5). doi:10.3892/ETM.2021.10779
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Michał Leśkiewicz, Piotr Daniel, Justyna Składanek, Karina Otręba, Joanna Cieszkowska, Karolina Czupryńska
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 208
Number of citations: 0