Increased Incidence of Thrombotic Complications With Non-small Cell Lung Cancer Necessitates Consideration of Prophylactic Anticoagulation in Young Individuals

Arindam Bagchi; Mohammad Saud Khan; Arti Saraswat; Affan Ansari; Qiang Nai; Veena Iyer; Danae Hamouda; Sadik Khuder; Cherian Verghese

doi:10.7759/cureus.17769

Increased Incidence of Thrombotic Complications With Non-small Cell Lung Cancer Necessitates Consideration of Prophylactic Anticoagulation in Young Individuals

Cureus. 2021 Sep 6;13(9):e17769. doi: 10.7759/cureus.17769. eCollection 2021 Sep.

Authors

Arindam Bagchi¹, Mohammad Saud Khan², Arti Saraswat³, Affan Ansari⁴, Qiang Nai⁵, Veena Iyer⁶, Danae Hamouda⁷, Sadik Khuder⁸, Cherian Verghese⁷

Affiliations

¹ Oncology, Beckley Appalachian Regional Healthcare (ARH) Hospital, Beckley, USA.
² Cardiology, University of Kentucky College of Medicine, Bowling Green, USA.
³ Internal Medicine, University of Kentucky College of Medicine, Bowling Green, USA.
⁴ Internal Medicine, Vasantrao Pawar Medical College and Hospital, Nashik, IND.
⁵ Oncology, Massachusetts General Cancer Center, Boston, USA.
⁶ Oncology, Brigham and Women Hospital, Boston, USA.
⁷ Oncology, University of Toledo Medical Center, Toledo, USA.
⁸ Internal Medicine, University of Toledo Medical Center, Toledo, USA.

Abstract

Venous thromboembolism (VTE) is a common complication in cancer patients and is associated with increased morbidity and mortality. Lung cancer is commonly associated with VTE including pulmonary embolism. We did a retrospective analysis from the 2013 Healthcare Cost and Utilization Project data to determine the role of age as a factor in the development of VTE in this patient group. Patients were selected using the International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes for metastatic lung cancer and VTE. The patients were stratified by age, sex, race/ethnicity, and site of VTE. There was a total of 16,577 VTE events detected out of a total of 182,863 cases of metastatic lung cancer, representing 9% of the total cases. In patients under 65 years of age, there were 356.82 more cases of pulmonary embolism per 100,000 individuals compared to those older than 65 years (p<0.0001). The same age group also showed 374.83 more upper extremity VTE, 286.94 more non-pulmonary thoracic VTE, and 263.97 more abdominal VTE events per 100,000 individuals (p<0.0001). In conclusion, we found that patients under the age of 65 years had a significantly higher incidence of VTE, pulmonary embolism, upper extremity VTE as well as abdominal and non-pulmonary VTE.

Keywords: deep venous thrombosis (dvt); metastatic non-small cell lung cancer; mortality; oncology; pulmonary embolism (pe); venous thromboembolism (vte).