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Venous thromboembolic events (VTE) are a major cause of morbidity and mortality in patients with active malignancy. We aim to investigate the outcome and incidence of acute DVT and PE in hematological malignancies compared to all other malignancies. The National Readmission Database (2016-2020) was utilized to identify all-cause admissions for patients with active hematological cancers. A Propensity Score Matching (PSM) model, matched such patients with subjects having any type of other malignancies. Multivariate regression & Mahalanobis distance propensity matching were used to compare outcomes. Among 3 million all-cause hospitalizations of patients with hematological cancers, about 4. 5% suffered an acute VTE. The majority had DVT (2. 7%), followed by PE (1. 2%) & DVT with PE (0. 6%). On a propensity-matched & multivariate analysis, patients with hematological cancers have a higher incidence of DVT (3% vs 2. 8%, aOR: 1. 08) but a lower incidence of PE (1. 2% vs 2. 1%, aOR: 0. 54) & DVT with PE (0. 6% vs 1. 1%, aOR: 0. 53) p <0. 001 as compared to other malignancies. Among different VTEs, the mortality was highest for acute PE (aOR: 2. 12), followed by DVT with PE (aOR: 1. 86) & DVT (aOR: 1. 66) p <0. 001 Resource utilization is also higher in hematological cancers complicated by VTE, with patients suffering a DVT having the highest LOS (9 vs 5 days) & almost twice the total cost of hospitalization (29, 660 vs 15, 279) p<0. 001. Similar rates of higher resource utilization are seen in PE & DVT with PE cohorts. Interestingly, patients with DVT have higher readmission rates as compared to PE at 30 days (23. 4% vs 21. 6%, p <0. 001) and 90-day intervals. Hospitalization in hematological cancers has a higher incidence of DVT but lower rates of PE and DVT with PE as compared to other malignancies. The mortality was highest for PE in this cohort, while healthcare-related burden and readmission rates were higher for DVT.
Ali et al. (Wed,) studied this question.