Predictors and outcomes of venous thromboembolism in hospitalized lung cancer patients: A Nationwide Inpatient Sample database analysis

Abstract

Background: Patients with lung cancer are at high risk of developing venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism. We sought to characterize the clinical factors associated with development of VTE and the impact of VTE on outcomes for hospitalized lung cancer patients.

Methods: We analyzed data captured in the Nationwide Inpatient Sample (NIS) database of the Agency of Healthcare Research and Quality (AHRQ). The study included all lung cancer patients hospitalized between 2006 and 2010 who had VTE captured as one of the top three discharge diagnoses. Demographics and outcomes of this population were compared to those of inpatient lung cancer patients without a VTE diagnosis. All analyses were performed using SAS version 9.3.

Results: Out of 570,304 lung cancer hospitalizations, 20,672 had a clinically relevant diagnosis of VTE, accounting for 3.6% of all events. The median age of lung cancer patients with VTE was 68 years; 48% were females, 79% were Caucasians, and 43% had metastatic disease. When compared to a lung cancer cohort without VTE (n=502,153), patients with VTE had significantly longer length of stay (LOS) (7.15 days vs. 6.05 days, OR 1.12), higher inpatient mortality (10.03% vs. 8.69%, OR 1.06), higher total hospital charges ($43,800 vs. $37,800, OR 1.07), and greater likelihood of moderate to severe disability upon discharge (55% vs. 49%, OR 1.23).

Conclusions: VTE in hospitalized lung cancer patients is associated with longer LOS, higher inpatient mortality rates, increased cost and greater disability upon discharge compared to other inpatient lung cancer patients.

Keywords: Lung cancer; Outcomes; Thromboembolism; Utilization; VTE.