Venous thromboembolism

Zachary P. Kahler, Jeffrey Kline

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Emergency physicians routinely care for oncology patients who are dually afflicted with venous thromboembolic disease. This dual diagnosis affects 5 % of all cancer patients in the USA and worsens both prognosis for the initial cancer diagnosis and the outcomes from the thrombosis. Several cancers are at particularly high risk for subsequent thrombosis, including adenocarcinoma, myeloma, and promyelocytic leukemia. Chemotherapeutic agents, such as 5-FU, thalidomide derivatives, and asparaginase, independently increase the risk of thrombosis. Further, active cancer complicates the diagnostic work-up by inherently imposing a moderate or higher risk of thrombosis and causing more false-positive testing with the D-dimer assay. Cancer leads to incidental pulmonary embolism diagnosis found on about 2-4 % of computerized tomographic scanning done for cancer staging and surveillance, and the current practice is to treat these patients with full-dose anticoagulation. Treatment requires unfractionated heparin during the entire time that cancer is thought to be active, and cancer patients have a higher rate of bleeding during treatment. Advanced therapy, such as systemic or catheter-directed fibrinolysis, has not been subjected to rigorous testing in clinical trials of cancer patients.

Original languageEnglish (US)
Title of host publicationOncologic Emergency Medicine: Principles and Practice
PublisherSpringer International Publishing
Pages203-210
Number of pages8
ISBN (Electronic)9783319263878
ISBN (Print)9783319263854
DOIs
StatePublished - Jan 1 2016

Fingerprint

Venous Thromboembolism
Neoplasms
Thrombosis
Dual (Psychiatry) Diagnosis
Asparaginase
Thalidomide
Neoplasm Staging
Fibrinolysis
Pulmonary Embolism
Fluorouracil
Heparin
Patient Care
Leukemia
Adenocarcinoma
Emergencies
Therapeutics
Catheters
Clinical Trials
Hemorrhage
Physicians

Keywords

  • Bleeding risks
  • Cancer
  • Deep vein thrombosis
  • Prognosis
  • Pulmonary embolism
  • VTE

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kahler, Z. P., & Kline, J. (2016). Venous thromboembolism. In Oncologic Emergency Medicine: Principles and Practice (pp. 203-210). Springer International Publishing. https://doi.org/10.1007/978-3-319-26387-8_17

Venous thromboembolism. / Kahler, Zachary P.; Kline, Jeffrey.

Oncologic Emergency Medicine: Principles and Practice. Springer International Publishing, 2016. p. 203-210.

Research output: Chapter in Book/Report/Conference proceedingChapter

Kahler, ZP & Kline, J 2016, Venous thromboembolism. in Oncologic Emergency Medicine: Principles and Practice. Springer International Publishing, pp. 203-210. https://doi.org/10.1007/978-3-319-26387-8_17
Kahler ZP, Kline J. Venous thromboembolism. In Oncologic Emergency Medicine: Principles and Practice. Springer International Publishing. 2016. p. 203-210 https://doi.org/10.1007/978-3-319-26387-8_17
Kahler, Zachary P. ; Kline, Jeffrey. / Venous thromboembolism. Oncologic Emergency Medicine: Principles and Practice. Springer International Publishing, 2016. pp. 203-210
@inbook{bb7ebb5f4a1045b09508a1498f5e4920,
title = "Venous thromboembolism",
abstract = "Emergency physicians routinely care for oncology patients who are dually afflicted with venous thromboembolic disease. This dual diagnosis affects 5 {\%} of all cancer patients in the USA and worsens both prognosis for the initial cancer diagnosis and the outcomes from the thrombosis. Several cancers are at particularly high risk for subsequent thrombosis, including adenocarcinoma, myeloma, and promyelocytic leukemia. Chemotherapeutic agents, such as 5-FU, thalidomide derivatives, and asparaginase, independently increase the risk of thrombosis. Further, active cancer complicates the diagnostic work-up by inherently imposing a moderate or higher risk of thrombosis and causing more false-positive testing with the D-dimer assay. Cancer leads to incidental pulmonary embolism diagnosis found on about 2-4 {\%} of computerized tomographic scanning done for cancer staging and surveillance, and the current practice is to treat these patients with full-dose anticoagulation. Treatment requires unfractionated heparin during the entire time that cancer is thought to be active, and cancer patients have a higher rate of bleeding during treatment. Advanced therapy, such as systemic or catheter-directed fibrinolysis, has not been subjected to rigorous testing in clinical trials of cancer patients.",
keywords = "Bleeding risks, Cancer, Deep vein thrombosis, Prognosis, Pulmonary embolism, VTE",
author = "Kahler, {Zachary P.} and Jeffrey Kline",
year = "2016",
month = "1",
day = "1",
doi = "10.1007/978-3-319-26387-8_17",
language = "English (US)",
isbn = "9783319263854",
pages = "203--210",
booktitle = "Oncologic Emergency Medicine: Principles and Practice",
publisher = "Springer International Publishing",

}

TY - CHAP

T1 - Venous thromboembolism

AU - Kahler, Zachary P.

AU - Kline, Jeffrey

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Emergency physicians routinely care for oncology patients who are dually afflicted with venous thromboembolic disease. This dual diagnosis affects 5 % of all cancer patients in the USA and worsens both prognosis for the initial cancer diagnosis and the outcomes from the thrombosis. Several cancers are at particularly high risk for subsequent thrombosis, including adenocarcinoma, myeloma, and promyelocytic leukemia. Chemotherapeutic agents, such as 5-FU, thalidomide derivatives, and asparaginase, independently increase the risk of thrombosis. Further, active cancer complicates the diagnostic work-up by inherently imposing a moderate or higher risk of thrombosis and causing more false-positive testing with the D-dimer assay. Cancer leads to incidental pulmonary embolism diagnosis found on about 2-4 % of computerized tomographic scanning done for cancer staging and surveillance, and the current practice is to treat these patients with full-dose anticoagulation. Treatment requires unfractionated heparin during the entire time that cancer is thought to be active, and cancer patients have a higher rate of bleeding during treatment. Advanced therapy, such as systemic or catheter-directed fibrinolysis, has not been subjected to rigorous testing in clinical trials of cancer patients.

AB - Emergency physicians routinely care for oncology patients who are dually afflicted with venous thromboembolic disease. This dual diagnosis affects 5 % of all cancer patients in the USA and worsens both prognosis for the initial cancer diagnosis and the outcomes from the thrombosis. Several cancers are at particularly high risk for subsequent thrombosis, including adenocarcinoma, myeloma, and promyelocytic leukemia. Chemotherapeutic agents, such as 5-FU, thalidomide derivatives, and asparaginase, independently increase the risk of thrombosis. Further, active cancer complicates the diagnostic work-up by inherently imposing a moderate or higher risk of thrombosis and causing more false-positive testing with the D-dimer assay. Cancer leads to incidental pulmonary embolism diagnosis found on about 2-4 % of computerized tomographic scanning done for cancer staging and surveillance, and the current practice is to treat these patients with full-dose anticoagulation. Treatment requires unfractionated heparin during the entire time that cancer is thought to be active, and cancer patients have a higher rate of bleeding during treatment. Advanced therapy, such as systemic or catheter-directed fibrinolysis, has not been subjected to rigorous testing in clinical trials of cancer patients.

KW - Bleeding risks

KW - Cancer

KW - Deep vein thrombosis

KW - Prognosis

KW - Pulmonary embolism

KW - VTE

UR - http://www.scopus.com/inward/record.url?scp=85013078010&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013078010&partnerID=8YFLogxK

U2 - 10.1007/978-3-319-26387-8_17

DO - 10.1007/978-3-319-26387-8_17

M3 - Chapter

AN - SCOPUS:85013078010

SN - 9783319263854

SP - 203

EP - 210

BT - Oncologic Emergency Medicine: Principles and Practice

PB - Springer International Publishing

ER -