J Card Surg in press

The effect of catheter-directed thrombolytic use on readmission rates and in-hospital
outcomes among cancer patients with venous thromboembolism in the United States.

Guha A, McKinley G, Dey AK, Carter R, Miller PE, Deshmukh AJ, Zaghlol R, Barac A, Desai NR, Addison D

BACKGROUND : Cancer inducing a hypercoagulable state, venous thromboembolism (VTE) remains a leading cause of morbidity and mortality globally. We assessed the impacts of cancer on the likelihood for readmission after a VTE-targeted procedure.

METHODS : We created a new cohort using discharge-level data from all hospitalizations from State Inpatient Databases of geographically dispersed participating states (18-27 states).

RESULTS : In those presenting with VTE during index-admission (619 241), 2.4% patients underwent catheter directed thrombolytic therapy (CDL) on index admission and among those 20.3% had cancer. Moreover, the 30-day readmission rate amongst CDL recipients (10 776 overall) was 14.3% in those with cancer compared to 8.8% in those with no cancer history (P < .0001). Additionally, in-hospital mortality (5.7% vs 1.1%; P = 0.009) and cost-of-care ($11 014 ± 914 vs $10 520 ± 534; P = .04) was significantly higher in cancer compared to noncancer.

CONCLUSION : The use of CDL does not appear to reduce the risk of returning for a VTE-related admission in cancer.