# Nationally representative estimates of health care burden of venous thromboembolism in hospitalized cancer patients

## TL;DR

This study shows that cancer patients with venous thromboembolism (VTE) face higher mortality, longer hospital stays, and higher costs compared to cancer patients without VTE.

## Contribution

The study provides nationally representative data on the health care burden of VTE in hospitalized cancer patients in the U.S.

## Key findings

- VTE co-diagnosis occurred in 8% of cancer hospitalizations, with DVT and PE being the most common.
- Cancer patients with VTE had significantly higher mortality, longer hospital stays, and higher charges.
- Black patients had elevated odds of VTE and higher mortality compared to non-Black patients.

## Abstract

Venous thromboembolism (VTE) is a frequent and often preventable cancer-related comorbidity.

This study evaluated national health care burden of patients hospitalized with cancer and VTE diagnoses.

The 2021 Nationwide Inpatient Sample was used to generate nationally representative estimates of cancer-associated thrombotic events identified via International Classification of Diseases-10 coding. Adjusted odds ratios (aOR) for co-diagnosis rate and all-cause mortality, median hospital charges, and length of stay (LOS) for cancer admissions with and without VTE were calculated.

Of 28,443,009 adult US hospitalizations in 2021, 2,907,118 (10.2%) listed cancer as a diagnosis. Of these, 234,090 (8.1%) had co-diagnosis of VTE: pulmonary embolism (PE), 96,335 (41%); deep vein thrombosis (DVT), 172,315 (74%); and PE+DVT, 34,560 (15%). Median age for admissions with cancer and VTE was 67 years (IQR, 58-76 years), with 87.6% admissions classified as major/severe underlying illness. VTE and cancer occurred at significantly higher rates than noncancer admissions (adjusted odds ratio [aOR], 1.81; 95% CI, 1.79-1.83; P < .001; PE: aOR, 1.54; 95% CI, 1.51-1.56; P < .001); DVT: aOR, 1.94; 95% CI, 1.91-1.96; P < .001)]. Odds of all-cause mortality for cancer admissions with VTE was higher as than without (aOR, 1.61; 95% CI, 1.56-1.67; P < .001; DVT: aOR, 1.41; 95% CI, 1.36-1.47; P < .001; PE: aOR, 1.88; 95% CI, 1.79-1.97; P < .001). Analysis by race found Blacks had elevated VTE odds (aOR, 1.29; 95% CI, 1.26-1.33; P < .001), and Blacks with VTE had elevated mortality odds (aOR, 1.15; 95% CI, 1.11-1.19; P < .001), compared with non-Blacks. Cancer hospitalizations with VTE were associated with significantly longer median LOS (6 days [IQR, 3-11 days] vs 4 days [IQR, 2-8 days]; P < .001) and higher median hospital charges ($70,416 [IQR, $36,257-$146,218] vs $55,887 [IQR, $30,276-$105,637]; P < .001)].

This report on contemporary national data shows co-diagnosis of VTE and cancer is associated with significantly higher all-cause mortality, LOS, and total hospital expenditures than cancer admissions without VTE. These findings underscore importance of accurate VTE risk assessment for inpatients with cancer.

•Venous thromboembolism (VTE) is a frequent complication among patients with cancer.•Co-diagnoses of VTE and cancer were evaluated via the 2021 National Inpatient Sample.•VTE co-diagnosis was associated with 8% of cancer-associated hospitalizations.•Patients with cancer and VTE had higher associated mortality, length of stay, and charges.

Venous thromboembolism (VTE) is a frequent complication among patients with cancer.

Co-diagnoses of VTE and cancer were evaluated via the 2021 National Inpatient Sample.

VTE co-diagnosis was associated with 8% of cancer-associated hospitalizations.

Patients with cancer and VTE had higher associated mortality, length of stay, and charges.