title: Epidemiology of venous thromboembolism in 9489 patients with malignant glioma.
abstract: OBJECTIVE
  The authors sought to define the incidence of symptomatic venous thromboembolism (VTE) in patients harboring malignant gliomas.
  
  
  METHODS
  The authors conducted a retrospective analysis of data obtained in all cases of malignant glioma diagnosed in California during a 6-year period; the occurrence of a VTE was identified using linked hospital discharge data. The Cox proportional hazard model was used to analyze the association of specific risk factors with the development of a VTE or death within 2 years of the cancer diagnosis. Among 9489 cases, the 2-year cumulative incidence of VTE was 7.5% (715 cases), with a rate of 16.1 events per 100 person-years during the first 6 months. Three hundred ninety-one (55%) of these 715 cases were diagnosed within 61 days of major neurosurgery. Risk factors for VTE included older age (hazard ratio [HR] 2.6, confidence interval [CI] 2.0-3.4 for age range 65-74 years compared with < or = 45 years), glioblastoma multiforme histology (HR 1.7, CI 1.4-2.1), three or more chronic comorbidities (HR 3.5, CI 2.8-4.3 [compared with no comorbidity]), and neurosurgery within 61 days (HR 1.7, CI 1.3-2.3). Patients in whom a VTE was present were at higher risk of dying within 2 years (HR 1.3, CI 1.2-1.4). In a nested case-control analysis of all VTE cases, there was no association between insertion of a vena cava filter and the risk of a recurrent VTE.
  
  
  CONCLUSIONS
  In patients harboring a glioma there was a very high incidence of symptomatic VTEs, particularly within 2 months of neurosurgery. The development of a VTE was associated with a 30% increase in the risk of death within 2 years. Further studies are needed to determine if risk stratification and the use of medical prophylaxis after neurosurgery improves outcomes.
authors: Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, California 95817, USA.
authors: Thomas J
authors: TJ
authors: Semrad
authors: Robert
authors: R
authors: O'Donnell
authors: Ted
authors: T
authors: Wun
authors: Helen
authors: H
authors: Chew
authors: Danielle
authors: D
authors: Harvey
authors: Hong
authors: H
authors: Zhou
authors: Richard H
authors: RH
authors: White
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D005910:Glioma / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control; D013997:Time Factors; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000517:prevention & control