Predictors of survival of patients with cancer-associated thrombosis: Experience from a tertiary hospital in Sub-Saharan Africa.

Abstract

e24127 Background: Cancer significantly increases the risk of thrombosis. Recent advances in cancer treatment may have led to more cases of cancer-associated thrombosis (CAT). CAT is linked with substantial morbidity and mortality. Methods: This study aimed to assess the clinical characteristics, treatment patterns, and survival outcomes of patients with CAT at Tikur Anbessa Specialized Hospital (TASH), a tertiary hospital in Addis Ababa, Ethiopia. A single-center institution-based retrospective study was done on 274 patients with CAT. A structured, original data abstraction tool was used to extract data from patients' medical records. Bivariate and multivariate binary logistic regression were used to determine factors associated with 1-year mortality. Results: The median (interquartile range (IQR)) age of the patients was 48 (18-87) years, and 183 (66.8%) of them were female. 106 (38.7%) of the patients had at least one comorbidity. The median (IQR) values for the Charlson Comorbidity Index (CCI) and Khorana Risk Score were 5.5 (2.0-7.0) and 1 (0-2), respectively. Gynecological malignancies were the most common cancers associated with thrombosis (29.1%), followed by hematological malignancies (24.4%) and intra-abdominal malignancies (18.2%). The three most common types of thrombosis identified were deep vein thrombosis (DVT) (72.6%), pulmonary embolism (PE) (10.9%), and portal vein thrombosis (PVT) (10.9%). The most frequently utilized anticoagulant was rivaroxaban (40.1%), followed by warfarin (38.0%). The one-year overall survival rate was 81%, and higher Khorana Risk Score (adjusted odds ratio (AOR), 1.55; 95% confidence interval (CI), 1.17-2.07; p = 0.003) and having solid organ malignancies (AOR, 2.98; 95% CI, 1.10-8.07; P = 0.032) were significantly associated with increased 1-year mortality. Conclusions: In this cohort, the one-year survival rate for patients with CAT was higher than previously reported in regional studies. The Khorana Risk Score and the type of malignancy were significant predictors of survival.