Association of risk factors for venous thromboembolism and overall survival in lung cancer

Blood Vessels, Thrombosis & Hemostasis Pub Date : 2025-05-09 DOI:10.1016/j.bvth.2025.100074

Thomas E. Plate ∗ , Asaad Trabolsi ∗ , Rachel S. Kronenfeld , Leticia E. Campoverde , Dan Morgenstern-Kaplan , Alyssa J. Mercadel , Michael Caballero , Wei Zhao , Gerald A. Soff

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Abstract

Venous thromboembolism (VTE) is a frequent complication in patients with lung cancer, but the risk factors and incidence in different lung cancer subtypes have not been fully characterized. Despite multiple studies supporting the use of VTE prophylaxis in patients with cancer at increased risk of VTE based on the Khorana score (KS), routine use of VTE prophylaxis is uncommon in clinical practice. This study further characterizes the risk factors and incidence of VTE in patients with lung cancer at a university cancer center. Furthermore, we assessed the association of KS and its individual components with overall survival in this same group of patients. Using natural language processing and human review to detect thrombotic events in the electronic medical record, a 12-month incidence of 10.1% was identified in the 632 patients with lung cancer analyzed. Significant risk factors included age <60 years and white blood cell (WBC) count ≥11 × 10⁹/L, but KS itself was not significantly associated with VTE. The median overall survival was 12 months with VTE. The KS, age ≥60 years, stage III to IV, WBC count ≥11 × 10⁹/L, hemoglobin <10 g/dL, body mass index, surgery, and VTE were identified as significant predictors of death. These findings warrant further validation, because the KS and 2 of its individual components in this study of lung cancer were significantly associated with reduced overall survival.

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肺癌静脉血栓栓塞危险因素与总生存率的关系

摘要静脉血栓栓塞（venous thromboembolism， VTE）是肺癌患者的常见并发症，但其危险因素及在不同肺癌亚型中的发病率尚未完全明确。尽管多项研究支持在基于Khorana评分（KS）的静脉血栓栓塞风险增加的癌症患者中使用静脉血栓栓塞预防，但在临床实践中常规使用静脉血栓栓塞预防并不常见。本研究进一步分析了某大学癌症中心肺癌患者静脉血栓栓塞的危险因素和发生率。此外，我们在同一组患者中评估了KS及其个体成分与总生存率的关系。使用自然语言处理和人工回顾来检测电子病历中的血栓事件，在分析的632例肺癌患者中确定了12个月的发病率为10.1%。年龄≥60岁、白细胞(WBC)≥11 × 109/L为显著危险因素，但KS本身与VTE无显著相关性。静脉血栓栓塞患者的中位总生存期为12个月。KS、年龄≥60岁、III至IV期、WBC计数≥11 × 109/L、血红蛋白≥10 g/dL、体重指数、手术和静脉血栓栓塞被认为是死亡的重要预测因素。这些发现值得进一步验证，因为在这项肺癌研究中，KS及其2个单独成分与总生存率降低显著相关。

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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Blood Vessels, Thrombosis & Hemostasis

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