Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample
<b>Background:</b> Pancreatic cancer can induce a hypercoagulable state which may lead to clinically apparent thrombosis. However, the effect of anticoagulants remains ambiguous. This study aimed to investigate the potential effect of long-term systemic anticoagulant usage on hospitaliza...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/7/1985 |
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| author | Yen-Min Huang Hsuan-Jen Shih Yi-Chan Chen Tsan-Yu Hsieh Che-Wei Ou Po-Hsu Su Shih-Ming Chen Yun-Cong Zheng Li-Sung Hsu |
| author_facet | Yen-Min Huang Hsuan-Jen Shih Yi-Chan Chen Tsan-Yu Hsieh Che-Wei Ou Po-Hsu Su Shih-Ming Chen Yun-Cong Zheng Li-Sung Hsu |
| author_sort | Yen-Min Huang |
| collection | DOAJ |
| description | <b>Background:</b> Pancreatic cancer can induce a hypercoagulable state which may lead to clinically apparent thrombosis. However, the effect of anticoagulants remains ambiguous. This study aimed to investigate the potential effect of long-term systemic anticoagulant usage on hospitalization outcomes of patients with pancreatic cancer. <b>Methods:</b> This retrospective study extracted all data from the U.S. Nationwide Inpatient Sample (NIS) database from 2005 to 2018. We included hospitalized adults ≥18 years old with a pancreatic cancer diagnosis identified by International Classification of Diseases ninth revision (ICD-9) and tenth revision (ICD-10) codes. We utilized diagnostic codes ICD9 V58.61 and ICD10 Z79.01, i.e., ‘long-term use of anticoagulant’, to identify individuals who were on a long-term systemic anticoagulant. The study cohort were then further grouped as being with or without long-term systemic use of an anticoagulant. Propensity score matching was performed to balance the characteristics of the two groups. The risks of life-threatening events, e.g., acute myocardial infarction (AMI), acute heart failure (AHF), sepsis, shock, and acute kidney injury (AKI), in-hospital death, and prolonged length of stay (LOS) in the hospital were compared between the groups by univariable and multivariable logistic regression analyses. <b>Results:</b> The study population consisted of 242,903 hospitalized patients with pancreas cancer, 6.5% (<i>n</i> = 15,719) of whom were on long-term systemic anticoagulants. A multivariable regression analysis showed that long-term systemic anticoagulant use was independently associated with lower odds of sepsis (aOR: 0.81, 95% CI: 0.76–0.85), shock (aOR: 0.59, 95% CI: 0.51–0.68), AKI (aOR: 0.86, 95% CI: 0.81–0.91), in-hospital mortality (aOR: 0.65, 95% CI: 0.60–0.70), and prolonged LOS (aOR: 0.84, 95% CI: 0.80–0.89). <b>Conclusions:</b> Long-term systemic anticoagulant use is associated with better clinical outcomes in terms of decreased risks of some life-threatening events, in-hospital death, and prolonged LOS among hospitalized patients with pancreatic cancer in the U.S. |
| first_indexed | 2024-03-11T05:41:30Z |
| format | Article |
| id | doaj.art-0394187effd547e29d11a4f37ca09ad0 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T05:41:30Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-0394187effd547e29d11a4f37ca09ad02023-11-17T16:24:28ZengMDPI AGCancers2072-66942023-03-01157198510.3390/cancers15071985Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient SampleYen-Min Huang0Hsuan-Jen Shih1Yi-Chan Chen2Tsan-Yu Hsieh3Che-Wei Ou4Po-Hsu Su5Shih-Ming Chen6Yun-Cong Zheng7Li-Sung Hsu8Hemophilia and Thrombosis Treatment Center, Division of Hematology and Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung 204, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of General Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, TaiwanDepartment of Pathology, Keelung Chang Gung Memorial Hospital, Keelung 204, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanHemophilia and Thrombosis Treatment Center, Division of Hematology and Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung 204, TaiwanBachelor Program in Health Care and Social Work for Indigenous Students, Providence University, Taichung 433, TaiwanDepartments of Neurosurgery, Keelung Chang Gung Memorial Hospital, Keelung 204, TaiwanInstitute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan<b>Background:</b> Pancreatic cancer can induce a hypercoagulable state which may lead to clinically apparent thrombosis. However, the effect of anticoagulants remains ambiguous. This study aimed to investigate the potential effect of long-term systemic anticoagulant usage on hospitalization outcomes of patients with pancreatic cancer. <b>Methods:</b> This retrospective study extracted all data from the U.S. Nationwide Inpatient Sample (NIS) database from 2005 to 2018. We included hospitalized adults ≥18 years old with a pancreatic cancer diagnosis identified by International Classification of Diseases ninth revision (ICD-9) and tenth revision (ICD-10) codes. We utilized diagnostic codes ICD9 V58.61 and ICD10 Z79.01, i.e., ‘long-term use of anticoagulant’, to identify individuals who were on a long-term systemic anticoagulant. The study cohort were then further grouped as being with or without long-term systemic use of an anticoagulant. Propensity score matching was performed to balance the characteristics of the two groups. The risks of life-threatening events, e.g., acute myocardial infarction (AMI), acute heart failure (AHF), sepsis, shock, and acute kidney injury (AKI), in-hospital death, and prolonged length of stay (LOS) in the hospital were compared between the groups by univariable and multivariable logistic regression analyses. <b>Results:</b> The study population consisted of 242,903 hospitalized patients with pancreas cancer, 6.5% (<i>n</i> = 15,719) of whom were on long-term systemic anticoagulants. A multivariable regression analysis showed that long-term systemic anticoagulant use was independently associated with lower odds of sepsis (aOR: 0.81, 95% CI: 0.76–0.85), shock (aOR: 0.59, 95% CI: 0.51–0.68), AKI (aOR: 0.86, 95% CI: 0.81–0.91), in-hospital mortality (aOR: 0.65, 95% CI: 0.60–0.70), and prolonged LOS (aOR: 0.84, 95% CI: 0.80–0.89). <b>Conclusions:</b> Long-term systemic anticoagulant use is associated with better clinical outcomes in terms of decreased risks of some life-threatening events, in-hospital death, and prolonged LOS among hospitalized patients with pancreatic cancer in the U.S.https://www.mdpi.com/2072-6694/15/7/1985systemic anticoagulantpancreatic cancermorbiditymortalityNationwide Inpatient Sample (NIS) |
| spellingShingle | Yen-Min Huang Hsuan-Jen Shih Yi-Chan Chen Tsan-Yu Hsieh Che-Wei Ou Po-Hsu Su Shih-Ming Chen Yun-Cong Zheng Li-Sung Hsu Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample Cancers systemic anticoagulant pancreatic cancer morbidity mortality Nationwide Inpatient Sample (NIS) |
| title | Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample |
| title_full | Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample |
| title_fullStr | Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample |
| title_full_unstemmed | Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample |
| title_short | Systemic Anticoagulation and Inpatient Outcomes of Pancreatic Cancer: Real-World Evidence from U.S. Nationwide Inpatient Sample |
| title_sort | systemic anticoagulation and inpatient outcomes of pancreatic cancer real world evidence from u s nationwide inpatient sample |
| topic | systemic anticoagulant pancreatic cancer morbidity mortality Nationwide Inpatient Sample (NIS) |
| url | https://www.mdpi.com/2072-6694/15/7/1985 |
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