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Rebecca Olin, MD, MS


Large-Scale Study of AML, Venous Thromboembolism, and Hospitalization Rates

By: Celeste L. Dixon
Posted: Tuesday, March 16, 2021

A retrospective study published in Postgraduate Medicine documents a U.S. trend in the incidence of venous thromboembolism in patients hospitalized for acute myeloid leukemia (AML), for the first time on such a wide scale in the literature, according to the authors. Shantanu Solanki, MD, MPH, of the Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania, and colleagues found a significant increase in the proportion of AML hospitalizations with venous thromboembolism between 2010 (0.47%) and 2014 (0.56%; P = .014), utilizing data from the Nationwide Inpatient Sample (NIS), which included 313,282 hospitalizations of adults with a primary diagnosis of AML.

Of note, multivariable regression analysis indicated that overall, in-hospital mortality was not significantly more likely in patients with venous thromboembolism than those without (P = .5). Three specific factors, however—advanced age, Black race, and lack of health insurance—were associated with a greater likelihood of in-hospital mortality for patients with AML who developed venous thromboembolism.

Being older than 84 carried the statistically most significant risk of mortality in this scenario (P < .0001), followed by being Black (P < .0001) or uninsured (P < .0001), wrote Dr. Solanki and co-investigators. The multivariable analysis added liver disease, paralysis, other neurologic disorder, renal failure, and weight loss to the list of predictors.

“The predictors of in-hospital mortality as reflected by our study are similar to predictors of in-hospital mortality among patients with metastatic carcinoma,” added the authors. “[They are] non-White race, lack of insurance, great burden of comorbidities, and renal failure.”

Disclosure: The study authors reported no conflicts of interest.

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