National trends in venous thromboembolism-related mortality among pancreatic cancer patients in the United States, 1999-2020.

IF 2.6 4区 医学 Q2 HEMATOLOGY
Ibrahim Nagmeldin Hassan, Mohamed Ibrahim, Siddig Yaqub, Muhsin Ibrahim, Haythem Abdalla, Ghada Aljaili, Wafa Osman, Nagmeldin Abuassa
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引用次数: 0

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) carries a high risk of venous thromboembolism (VTE), which significantly contributes to mortality. However, national trends in VTE-related deaths among this population remain poorly defined.

Methods: We conducted a cross-sectional analysis of U.S. mortality data from 1999 to 2020 using the CDC WONDER platform. Deaths were included if VTE was the underlying cause and pancreatic cancer a contributing cause. Age-adjusted mortality rates (AAMRs) were calculated, and Joinpoint regression was used to assess temporal trends, with subgroup analyses by sex, race/ethnicity, age, region, urbanization level, and place of death.

Results: A total of 20,373 VTE-related deaths occurred in pancreatic cancer patients. The overall AAMR was 0.36 per 100,000 population. A significant increase in mortality was observed, particularly from 2016 to 2020 (APC: 8.71%; p = 0.0039). Males had a higher AAMR than females (0.46 vs. 0.35). Black individuals experienced the highest mortality rate (0.62), followed by White (0.40) and Hispanic (0.36) populations. The burden increased sharply with age, peaking in the 75-84 age group (1.67). Geographic variation was notable, with the Midwest and West showing the highest AAMRs. Urban-rural differences were minimal, though trends rose in both settings. One-third (31.4%) of deaths occurred at home, highlighting potential gaps in outpatient management and end-of-life care.

Conclusion: VTE-related mortality in pancreatic cancer is rising, with disproportionate effects on older adults, males, and Black individuals. These findings highlight the need for tailored prevention strategies, equitable care access, and better integration of palliative services.

1999-2020年美国胰腺癌患者静脉血栓栓塞相关死亡率的全国趋势
背景:胰腺导管腺癌(PDAC)具有静脉血栓栓塞(VTE)的高风险,这是导致死亡率的重要因素。然而,在这一人群中,静脉栓塞相关死亡的全国趋势仍然不明确。方法:我们使用CDC WONDER平台对1999年至2020年的美国死亡率数据进行了横断面分析。如果静脉血栓栓塞是潜在原因,胰腺癌是诱因,死亡也包括在内。计算年龄调整死亡率(AAMRs),并使用Joinpoint回归评估时间趋势,并按性别、种族/民族、年龄、地区、城市化水平和死亡地点进行亚组分析。结果:共有20,373例胰腺癌患者发生vte相关死亡。总体AAMR为每10万人0.36。死亡率显著上升,特别是从2016年到2020年(APC: 8.71%;p = 0.0039)。男性的AAMR高于女性(0.46比0.35)。黑人的死亡率最高(0.62),其次是白人(0.40)和西班牙裔(0.36)。随着年龄的增长,负担急剧增加,在75-84岁年龄段达到高峰(1.67)。地理差异显著,中西部和西部的aamr最高。城乡差异很小,但两者的趋势都有所上升。三分之一(31.4%)的死亡发生在家中,凸显了门诊管理和临终关怀方面的潜在差距。结论:静脉血栓栓塞相关的胰腺癌死亡率正在上升,老年人、男性和黑人的影响不成比例。这些发现突出表明,有必要制定有针对性的预防战略、公平获得医疗服务以及更好地整合姑息治疗服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Thrombosis Journal
Thrombosis Journal Medicine-Hematology
CiteScore
3.80
自引率
3.20%
发文量
69
审稿时长
16 weeks
期刊介绍: Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.
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