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03-01-2024 | Thrombocytopenia | Original

Venous thromboembolism in critically ill adult patients with hematologic malignancy: a population-based cohort study

Authors: Federico C. Carini, Federico Angriman, Damon C. Scales, Laveena Munshi, Lisa D. Burry, Hassan Sibai, Sangeeta Mehta, Bruno L. Ferreyro, the SELECTION study group

Published in: Intensive Care Medicine | Issue 2/2024

Abstract

Purpose

The aim of this study was to describe the incidence of venous thromboembolism (VTE) and major bleeding among hospitalized patients with hematologic malignancy, assessing its association with critical illness and other baseline characteristics.

Methods

We conducted a population-based cohort study of hospitalized adults with a new diagnosis of hematologic malignancy in Ontario, Canada, between 2006 and 2017. The primary outcome was VTE (pulmonary embolism or deep venous thrombosis). Secondary outcomes were major bleeding and in-hospital mortality. We compared the incidence of VTE between intensive care unit (ICU) and non-ICU patients and described the association of other baseline characteristics and VTE.

Results

Among 76,803 eligible patients (mean age 67 years [standard deviation, SD, 15]), 20,524 had at least one ICU admission. The incidence of VTE was 3.7% in ICU patients compared to 1.2% in non-ICU patients (odds ratio [OR] 3.08; 95% confidence interval [CI] 2.77–3.42). The incidence of major bleeding was 7.6% and 2.4% (OR 3.33; 95% CI 3.09–3.58), respectively. The association of critical illness and VTE remained significant after adjusting for potential confounders (OR 2.92; 95% CI 2.62–3.25). We observed a higher incidence of VTE among specific subtypes of hematologic malignancy and patients with prior VTE (OR 6.64; 95% CI 5.42–8.14). Admission more than 1 year after diagnosis of hematologic malignancy (OR 0.64; 95% CI 0.56–0.74) and platelet count ≤ 50 × 10⁹/L at the time of hospitalization (OR 0.63; 95% CI 0.48–0.84) were associated with a lower incidence of VTE.

Conclusion

Among patients with hematologic malignancy, critical illness and certain baseline characteristics were associated with a higher incidence of VTE.

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Title: Venous thromboembolism in critically ill adult patients with hematologic malignancy: a population-based cohort study
Authors: Federico C. Carini
Federico Angriman
Damon C. Scales
Laveena Munshi
Lisa D. Burry
Hassan Sibai
Sangeeta Mehta
Bruno L. Ferreyro
the SELECTION study group
Publication date: 03-01-2024
Publisher: Springer Berlin Heidelberg
Keyword: Thrombocytopenia
Published in: Intensive Care Medicine / Issue 2/2024
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-023-07287-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Venous thromboembolism in critically ill adult patients with hematologic malignancy: a population-based cohort study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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