title: Prediction of venous thromboembolism in cancer patients.
abstract: The risk of venous thromboembolism (VTE) is increased in cancer patients. To improve prediction of VTE in cancer patients, we performed a prospective and observational cohort study of patients with newly diagnosed cancer or progression of disease after remission. A previously developed risk scoring model for prediction of VTE that included clinical (tumor entity and body mass index) and laboratory (hemoglobin level and thrombocyte and leukocyte count) parameters was expanded by incorporating 2 biomarkers, soluble P-selectin, and D-Dimer. Of 819 patients 61 (7.4%) experienced VTE during a median follow-up of 656 days. The cumulative VTE probability in the original risk model after 6 months was 17.7% in patients with the highest risk score (≥ 3, n = 93), 9.6% in those with score 2 (n = 221), 3.8% in those with score 1 (n = 229), and 1.5% in those with score 0 (n = 276). In the expanded risk model, the cumulative VTE probability after 6 months in patients with the highest score (≥ 5, n = 30) was 35.0% and 10.3% in those with an intermediate score (score 3, n = 130) as opposed to only 1.0% in patients with score 0 (n = 200); the hazard ratio of patients with the highest compared with those with the lowest score was 25.9 (8.0-84.6). Clinical and standard laboratory parameters with addition of biomarkers enable prediction of VTE and allow identification of cancer patients at high or low risk of VTE.
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Cihan
authors.initials: C
authors.lastname: Ay
authors.forename: Daniela
authors.initials: D
authors.lastname: Dunkler
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.forename: Alexandru-Laurentiu
authors.initials: AL
authors.lastname: Chiriac
authors.forename: Rainer
authors.initials: R
authors.lastname: Vormittag
authors.forename: Ralph
authors.initials: R
authors.lastname: Simanek
authors.forename: Peter
authors.initials: P
authors.lastname: Quehenberger
authors.forename: Christoph
authors.initials: C
authors.lastname: Zielinski
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
mesh_terms: D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000032:analysis; D001772:Blood Cell Count; D015992:Body Mass Index; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D019370:Observation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000209:etiology
chemical_list: D015415:Biomarkers; D006454:Hemoglobins