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ID 116140
タイトル別表記
レジストリデータによるがん患者の静脈血栓塞栓症の急性期死亡率
Thromboembolism and Cancer
著者
大櫛, 祐一郎 徳島大学大学院医科学教育部(医学専攻)
Okayama, Yoshihiro Tokushima University
Zheng, Robert Tokushima University
Nakai, Michikazu National Cerebral and Cardiovascular Center
Sumita, Yoko National Cerebral and Cardiovascular Center
キーワード
cardio-oncology
mortality
venous thromboembolism
Big data
資料タイプ
学位論文
抄録
BACKGROUND: The prognosis of patients with cancer-venous thromboembolism (VTE) is not well known because of a lack of registry data. Moreover, there is also no knowledge on how specific types are related to prognosis. We sought to evaluate the clinical characteristics and outcomes of patients with cancer-associated VTE, compared with a matched cohort without cancer using real-world registry data of VTE.
METHODS AND RESULTS: This study was based on the Diagnosis Procedure Combination database in the JROAD-DPC (Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination). Of 5 106 151 total patients included in JROAD-DPC, we identified 49 580 patients who were first hospitalized with VTE from April 2012 to March 2017. Propensity score was estimated with a logistic regression model, with cancer as the dependent variable and 18 clinically relevant covariates. After propensity matching, there were 25 148 patients with VTE with or without cancer. On propensity score-matched analysis with 25 148 patients with VTE, patients with cancer had higher total in-hospital mortality within 7 days (1.3% versus 1.1%, odds ratio [OR], 1.66; 95% CI, 1.31–2.11; P<0.0001), 14 days (2.5% versus 1.5%, OR, 2.07; 95% CI, 1.72–2.49; P<0.0001), and 30 days (4.8% versus 2.0%, OR, 2.85; 95% CI, 2.45–3.31; P<0.0001). On analysis for each type of cancer, in-hospital mortality in 11 types of cancer was significantly high, especially pancreas (OR, 12.96; 95% CI, 6.41–26.20), biliary tract (OR, 8.67; 95% CI, 3.00–25.03), and liver (OR, 7.31; 95% CI, 3.05–17.50).
CONCLUSIONS: Patients with cancer had a higher in-hospital acute mortality for VTE than those without cancer, especially in pancreatic, biliary tract, and liver cancers.
掲載誌名
Journal of the American Heart Association
ISSN
20479980
出版者
The American Heart Association
10
11
開始ページ
e019373
発行日
2021-05-22
備考
内容要旨・審査要旨・論文本文の公開
本論文は,著者Yuichiro Okushiの学位論文として提出され,学位審査・授与の対象となっている。
権利情報
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3531号
学位記番号
甲医第1501号
学位授与年月日
2021-07-29
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系