Background/Objectives: Venous thromboembolism (VTE) is associated with cancer, but we wanted to show VTE data for the last year of life, adjusting for age, sex, socioeconomic status and comorbidities. We also wanted to study the possible increase in VTE month by month, as well as time trends from 2015 to 2023. Methods: A cohort of 27,423 deceased people with cancer were analyzed witht-tests, chi-square tests and binary logistic regression models. Results: In total, 13.6% had at least one VTE episode during the last year of life and the VTE rate increased month by month (p< 0.0001). In adjusted models, higher VTE rates were associated with younger age and being a woman (p< 0.0001), both for all VTE as well as separately for pulmonary embolism (PE). The VTE rate increased by 47% from 11.1% in 2015 to 16.3% in 2023, and with significant differences for the pre-COVID-19 and COVID-19 years (i.e., 2015–2019 compared to 2020–2023,p< 0.0001). Conclusions: VTE is common in the last year of life and increases month by month. Higher frequencies are associated with female sex but especially with being younger, or having certain cancer forms such as pancreatic, gynecologic or lung cancer. The rate of VTE increased from 2015 to 2023. This is of interest as VTE has been associated with higher treatment intensity and with poorer prognosis and should be considered in the decision-making process.
背景/目的：静脉血栓栓塞症（VTE）与癌症相关，本研究旨在展示生命最后一年中经年龄、性别、社会经济状况及合并症调整后的VTE数据，并逐月分析VTE可能的增长趋势及2015年至2023年的时间变化规律。方法：对27,423名已故癌症患者队列进行t检验、卡方检验及二元逻辑回归模型分析。结果：总计13.6%的患者在生命最后一年至少发生一次VTE事件，且VTE发生率呈逐月上升趋势（p<0.0001）。经调整的模型显示，较高VTE发生率与较低年龄和女性性别相关（p<0.0001），这一关联在全因VTE及肺栓塞亚组中均成立。VTE发生率从2015年的11.1%上升至2023年的16.3%，增幅达47%，且新冠疫情前后时期（2015-2019年与2020-2023年对比）存在显著差异（p<0.0001）。结论：VTE在生命最后一年较为常见且呈逐月递增趋势。女性患者、年轻患者以及特定癌症类型（如胰腺癌、妇科肿瘤或肺癌）患者的VTE发生率更高。2015年至2023年间VTE发生率持续上升，鉴于VTE与更高治疗强度及不良预后相关，这一现象值得关注，应在临床决策过程中予以充分考虑。
High Rate of Thromboembolic Events in the Last Year of Life of Cancer Patients: A Registry Study
肿瘤(癌症)患者之家