Trends in Hospitalization and Mortality of Venous Thromboembolism in Hospitalized Patients With Colon Cancer and Their Outcomes: US Perspective

Clin Colorectal Cancer. 2017 Sep;16(3):e199-e204. doi: 10.1016/j.clcc.2016.09.006. Epub 2016 Sep 20.

Abstract

Introduction: Venous thromboembolism (VTE) is a major cause of morbidity and mortality in hospitalized patients with colon cancer. We assessed nationwide population-based trends in rates of hospitalization and mortality from VTE among patients with colon cancer to determine its impact.

Methods: We queried the Nationwide Inpatient Sample (NIS) database entries from 2003 to 2011 to identify patients with colon cancer. Bivariate group comparisons between hospitalized patients with colon cancer with VTE to those without VTE were made. Multivariate logistic regression analysis was used to obtain adjusted odds ratios. The Cochrane-Armitage test for linear trend was used to assess occurrences of VTE and mortality rates among patients with colon cancer.

Results: The total number patients with colon cancer was 1,502,743, of which 41,394 (2.75%) had VTE. The median age of the study population was 69 years; 51.5% were women. After adjusting for potential confounders, compared with those without VTE, patients with colon cancer with VTE had significantly higher inpatient mortality (6.26% vs. 5.52%, OR 1.15, P < .001) and greater disability at discharge (OR 1.38, P < .001), but were not associated with longer length of stay (LOS) or cost of hospitalization. From 2003 to 2011, despite an increase in hospitalization rate with VTE in patients with colon cancer, their mortality steadily declined.

Conclusion: VTE in hospitalized patients with colon cancer is associated with a significantly higher inpatient mortality and greater disability, but not with longer LOS or cost of hospitalization. Furthermore, even though there has been a trend toward more frequent hospitalizations in this patient population, their mortality continues to decline.

Keywords: Colon cancer; Epidemiology; Inpatients; Venous thromboembolism.

MeSH terms

  • Adult
  • Aged
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / mortality*
  • Female
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • United States / epidemiology
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / etiology*