Epidemiology, clinical profile and treatment patterns of venous thromboembolism in cancer patients in Taiwan: a population-based study.
BACKGROUND
Venous thromboembolism (VTE) is a clinically significant complication that is well documented among Caucasian cancer patients. However, evidence regarding VTE incidence and treatment among Asian cancer patients is very limited. The objective of this study is to investigate the incidence, risk factors and management of VTE among Taiwanese cancer patients.


METHODS
Using Taiwan's National Health Insurance Research Database, we identified 43,855 newly diagnosed cancer patients between 2001 and 2008. Two alternative algorithms for identifying VTE event were explored to better quantify a range of incidence rates of VTE in our cancer patients. Multivariable logistic regression models were used to explore VTE risk factors.


RESULTS
The incidence rates of VTE were 9.9 (algorithm 1) and 3.4 (algorithm 2) per 1,000 person-years, respectively. The incidence rates were higher in certain cancers, particularly liver, pancreas, and lung. Significant risk factors for VTE were site of cancer, prior history of VTE, chemotherapy and major surgeries. Long-term anticoagulant therapy was initiated in 64.1% patients with VTE and 72.2% of them received warfarin alone. Approximately two-thirds of patients with VTE received ≤ 3 months of anticoagulant therapy.


CONCLUSIONS
Incidence of cancer-related VTE is lower among Taiwanese compared to Caucasian populations. Nevertheless, risk factors for cancer-related VTE found in our study were consistent with current literature.
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, R220, 33, Linsen S. Road, Taipei, 10050, Taiwan. elwin0107@gmail.com.
Tan-Wei
TW
Chew
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, R220, 33, Linsen S. Road, Taipei, 10050, Taiwan. csgau206@cde.org.tw.|School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. csgau206@cde.org.tw.|Center for Drug Evaluation, Taipei, Taiwan. csgau206@cde.org.tw.
Churn-Shiouh
CS
Gau
Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Tao-Yuan, Taiwan. ywwen@mail.cgu.edu.tw.
Yu-Wen
YW
Wen
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, R220, 33, Linsen S. Road, Taipei, 10050, Taiwan. ljshen@ntu.edu.tw.|School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. ljshen@ntu.edu.tw.|Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. ljshen@ntu.edu.tw.
Li-Jiuan
LJ
Shen
University of Maryland School of Pharmacy, Baltimore, MD, USA. dmullins@rx.umaryland.edu.
C Daniel
CD
Mullins
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, R220, 33, Linsen S. Road, Taipei, 10050, Taiwan. fyshsiao@ntu.edu.tw.|School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. fyshsiao@ntu.edu.tw.|Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. fyshsiao@ntu.edu.tw.
Fei-Yuan
FY
Hsiao
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D012307:Risk Factors; D013624:Taiwan; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*
D000925:Anticoagulants