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Comparative outcomes of catheter–directed thrombolysis (CDT) with anticoagulation versus anticoagulation in cancer patients with deep vein thrombosis (DVT) are not known.
The nationwide inpatient sample (NIS) database was used to identify cancer patients who were admitted with principal diagnosis of proximal lower extremity or caval DVT between January 2005 and December 2010. We divided these patients into two groups. Group A – CDT plus anticoagulation and Group B – anticoagulation alone. We used propensity matching to compare the in–hospital outcomes of the two groups.
Amongst a total of 12,874 cancer patients with proximal lower extremity and or caval DVT, 423 patients were treated with CDT and anticoagulation whereas 12,451 patients were treated with anticoagulation alone. After propensity matching, we compared 423 patients in group A with 423 patients in group B. There was a non–significant trend toward higher mortality in the CDT group compared to anticoagulation alone group (3.5% vs 1.9%, p = 0.139). CDT group was noted to have higher blood transfusion (25.8% vs 17.7 %, p<0.01), renal failure (8.7% vs 4.3%, p<0.01), intracranial hemorrhage (1.4% vs 0.2%, p<0.06), and IVC filters placement rates (34% vs 24%, p<0.01). The length of stay (5.7+5.9 vs 9.1+8.1 days, p<0.01) and hospital charges ($35,527+46,597, vs 92,926+78,803, p<0.01) were also higher in the CDT group as compared to the anticoagulation alone group.
This observational study showed that in cancer patients with proximal lower extremity and or caval DVT, CDT plus anticoagulation is associated with a trend towards higher in–hospital mortality and statistically significant higher morbidity and resource utilization as compared with anticoagulation alone.
West, Room 3010
Sunday, March 10, 2013, 11:45 a.m.–Noon
Session Title: Vascular Medicine: The Future of Vascular Medicine and Venous Thromboembolism – 2013 Update
Abstract Category: 36. Vascular Medicine: Venous Disease
Presentation Number: 932–7
- 2013 American College of Cardiology Foundation