Risk factors associated with mortality from vascular thromboembolic events in patients diagnosed with non-small cell lung cancer: a population-based analysis
Background
Lung cancer patients are at increased risk for vascular events possibly due to cancer induced hypercoagulation.


Aim
The purpose of this study was to evaluate risk factors associated with the mortality from vascular thromboembolic events in patients diagnosed with non-small cell lung cancer (NSCLC).


Design
Retrospective population-based analysis.


Methods
We used Surveillance, Epidemiology, and End Results Program for 2004 - 2013 and evaluated 199,337 patients with NSCLC. Univariate and multivariate subdistribution hazard regression models were used to identify potential risk factors for mortality from vascular thromboembolic events. Stratification analysis against clinical stage was performed to determine if the severity of the disease influenced the identified associations.


Results
Multivariate Cox regression analysis demonstrated that increased risk of mortality due to vascular thromboembolic events was associated with age, black race, non-adenocarcinoma histology, surgical treatment alone (all, p < 0.001) and north central region of SEER registry (p = 0.003). Female gender (p < 0.001), Asian or Pacific Islander race (p = 0.001), multiple co-existing primary cancers and late cancer stages (both, p < 0.001) were associated with significantly lower risk of mortality due to vascular thromboembolic events. The significant predictors of mortality from the vascular thromboembolic event were dependent on the stages of the disease.


Conclusions
Risk factors associated with mortality from the vascular thromboembolic events in NSCLC patients identified in this study can promote awareness and may help to identify groups of patients that can benefit from antithrombotic prophylaxis measures.