Venous thromboembolism and acute myeloid leukemia: risk factors and mortality in elderly white, black and Asian patients.

IF 1.2 4区 医学 Q4 HEMATOLOGY
Ambarina S Faiz, Shuang Guo, Ashwin Sridharan, Yong Lin, Claire S Philipp
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Abstract

Risk factors for venous thromboembolism (VTE) in elderly patients with acute myeloid leukemia (AML) are not known by race. The aim of this study was to determine the association of VTE with known risk factors and the impact of VTE on mortality in elderly white, black and Asian patients with AML. The merged SEER-Medicare database (2000-2015) was used for patients aged at least 65 years diagnosed with AML. Multivariable logistic regression was used to examine the association of VTE with known risk factors and Cox proportional hazards regression was used to evaluate the association of VTE with mortality in white, black and Asian patients. Among 21 403 AML patients aged at least 65years, VTE was diagnosed in 10.6% of 18 731 white patients, 13.4% of 1362 black and 5.6% of 1310 Asian patients. Overall, the adjusted risk of VTE in black patients was similar to white patients, but Asian patients had a lower risk of VTE. Risk factors for VTE in white patients were age less than 75 years, female sex, chemotherapy and comorbid medical conditions, including hypertension, anemia, chronic kidney and lung disease, hyperlipidemia, heart failure and obesity. In black patients, hyperlipidemia, and heart failure and in Asian patients, age less than 75 years, female sex, chemotherapy and hypertension and myocardial infarction were associated with VTE. Central venous catheter placement was a predictor of VTE in all three races. Our study identified risk factors for VTE by race in elderly white, black and Asian AML patients.

静脉血栓栓塞和急性髓性白血病:老年白人、黑人和亚洲患者的危险因素和死亡率。
老年急性髓性白血病(AML)患者静脉血栓栓塞(VTE)的危险因素尚不清楚。本研究的目的是确定静脉血栓栓塞与已知危险因素的关系,以及静脉血栓栓塞对老年白人、黑人和亚洲AML患者死亡率的影响。合并的SEER-Medicare数据库(2000-2015)用于诊断为AML的年龄至少65岁的患者。采用多变量logistic回归检验静脉血栓栓塞与已知危险因素的关系,采用Cox比例风险回归评价静脉血栓栓塞与白人、黑人和亚洲患者死亡率的关系。在21403例65岁以上AML患者中,18731例白人患者中有10.6%诊断为静脉血栓栓塞,1362例黑人患者中有13.4%,1310例亚洲患者中有5.6%。总体而言,黑人患者的静脉血栓栓塞调整风险与白人患者相似,但亚洲患者的静脉血栓栓塞风险较低。白人静脉血栓栓塞患者的危险因素为年龄小于75岁、女性、化疗和合并症,包括高血压、贫血、慢性肾脏和肺部疾病、高脂血症、心力衰竭和肥胖。在黑人患者中,高脂血症、心力衰竭和亚洲患者中,年龄小于75岁、女性、化疗、高血压和心肌梗死与静脉血栓栓塞相关。在所有三个种族中,中心静脉导管放置是静脉血栓栓塞的预测因子。我们的研究确定了老年白人、黑人和亚洲AML患者的静脉血栓栓塞危险因素。
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Blood Coagulation & Fibrinolysis is an international fully refereed journal that features review and original research articles on all clinical, laboratory and experimental aspects of haemostasis and thrombosis. The journal is devoted to publishing significant developments worldwide in the field of blood coagulation, fibrinolysis, thrombosis, platelets and the kininogen-kinin system, as well as dealing with those aspects of blood rheology relevant to haemostasis and the effects of drugs on haemostatic components
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