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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
    2018-11
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/R35X25V55
  • License
    Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Master's
  • Department
    • Department of Medicine
  • Supervisor / co-supervisor and their department(s)
    • McMurtry, Sean M (Medicine)
    • Wu, Cynthia (Medicine)