title: Incidence and predictors of venous thromboembolism (VTE) among ambulatory patients with lung cancer.
abstract: BACKGROUND
  The incidence and economic impact of lung cancer-associated venous thromboembolic (VTE) events in a contemporary ambulatory setting is unknown.
  
  
  METHODS
  We conducted a retrospective cohort analysis utilizing the IMS Patient-Centric database of US healthcare claims and recorded VTE events occurring 3-12 months after chemotherapy initiation.
  
  
  RESULTS
  Lung cancer (n=6732) and control (n=17 284) cohorts had 51% women, with a mean age of 64 years. VTE occurred in 13.9% of the lung cancer cohort (odds ratio [OR], 3.15; 95% confidence interval [CI] 2.55, 3.89), and 1.4% of the control cohort (P<0.0001). Charlson Comorbidity Index ≥ 5 (CCI; OR, 2.56; 95% CI 1.02, 6.39; P=0.045), the use of erythropoiesis-stimulating agents (ESAs; OR, 1.63; 95% CI 1.40, 1.89; P<0.0001), and congestive heart failure (CHF; OR, 1.29; 95% CI 1.01, 1.66; P=0.045) were associated with VTE. Bleeding occurred in 22.1% of the lung cancer cohort and 7.0% of the control cohort (P<0.0001). Among lung cancer patients the average total healthcare payment was $84,187 in patients with VTE compared to $56,818 in patients without VTE (P<0.0001).
  
  
  CONCLUSIONS
  VTE is common among lung cancer patients receiving chemotherapy and is associated with increased healthcare utilization.
authors.affiliation: Department of Hematology and Oncology, University of Rochester, Rochester, NY 14642, USA. gregory_connolly@urmc.rochester.edu
authors.forename: G C
authors.initials: GC
authors.lastname: Connolly
authors.forename: M
authors.initials: M
authors.lastname: Dalal
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.forename: A A
authors.initials: AA
authors.lastname: Khorana
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D016015:Logistic Models; D008175:Lung Neoplasms / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011655:Pulmonary Embolism / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000191:economics / Q000453:epidemiology* / Q000209:etiology