Bleeding Risk in Cancer Patients with Acute Venous Thromboembolism in Alberta, Canada

  • Author / Creator
    Mansour, Sola
  • Background: Cancer-associated venous thromboembolism (VTE) is associated with significant
    morbidity and mortality. Cancer patients are at higher risk of VTE recurrence despite
    anticoagulation and bleeding complications while on anticoagulation. There are some risk factors
    of bleeding specific to cancer patients. We sought to assess the bleeding rates in cancer patients
    within one year of acute VTE over a 10-year period in Alberta, Canada and to identify whether
    cancer site affects these rates.
    Methods: Our population included all adult patients of Alberta diagnosed primarily with acute
    VTE between April 2002 and March 2012. We categorized patients into cancer and non-cancer
    population and we measured the bleeding rates in both groups then stratify by cancer site within
    the cancer group. We used purposeful logistic regression to calculate odds ratios and identify
    some predictors of bleeding.
    Results: Of 5,158 cases of cancer-associated VTE, 127 patients (2.46%) developed bleeding
    within one year of VTE event compared to 441 of 26,498 cases in the non-cancer group (1.66%)
    (p<0.0001). The main site of bleeding was gastrointestinal (91.34%) and the main site of cancer
    associated with higher bleeding risk was gastrointestinal cancer (OR 2.60; p=0.03). In terms of
    predictors of bleeding, the following risk factors contributed to the highest risk of bleeding:
    previous bleeding episode (OR 8.01; p<0.001), anemia (OR 5.72; p’0.001), liver disease (OR
    2.2; p<0.001), alcohol use (OR 1.97; p<0.001) and hypertension (OR 1.28; p=0.014).
    Conclusion: The bleeding risk is higher in cancer-associated VTE and it differs according to the
    cancer site. Bleeding is a big concern in cancer population and more efforts should be made to
    find the safest anticoagulant modality in each cancer type.

  • Subjects / Keywords
  • Graduation date
    Fall 2018
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
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