Predictors of anticoagulation in hospice patients with lung cancer

Holly M. Holmes, Kevin T. Bain, Ali Zalpour, Ruili Luo, Eduardo Bruera, James Goodwin

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: Guidelines recommend lifelong anticoagulation in patients with cancer and a history of thromboembolism, but the use of anticoagulation in hospice has not been described. A retrospective study of medication data was conducted to determine patterns of anticoagulant use and predictors of type of anticoagulant prescribed for hospice patients with lung cancer. METHODS: Medication data were evaluated for 16,896 hospice patients with lung cancer in 2006 to determine patient and hospice characteristics that predicted anticoagulant prescription. Independent predictors of warfarin versus low molecular weight heparin (LMWH) prescription were identified using a logistic regression model. RESULTS: One of every 11 patients was prescribed an anticoagulant, most commonly warfarin. Compared with patients prescribed LMWH, patients prescribed warfarin were older (71.6 vs 65.8 years, P<.001), were more likely white (81.2% vs 74.3%, P =.03), had a longer stay in hospice (median 21 days vs 17 days, P =.001), and were more likely to have ≥3 comorbid illnesses (37.5% vs 25.0%, P<.001). The strongest independent predictor of type of anticoagulant prescribed was geographic region, with hospices in the Northeast more likely to prescribe LMWH. CONCLUSIONS: Anticoagulant use is prevalent in patients with lung cancer enrolled in hospice. This study highlights the need to understand the benefits and risks of anticoagulation at the end of life.

Original languageEnglish (US)
Pages (from-to)4817-4824
Number of pages8
JournalCancer
Volume116
Issue number20
DOIs
StatePublished - 2010

Fingerprint

Hospices
Lung Neoplasms
Anticoagulants
Low Molecular Weight Heparin
Warfarin
Prescriptions
Logistic Models
Thromboembolism
Retrospective Studies
Guidelines

Keywords

  • Anticoagulants
  • Drug interactions
  • Hospice care
  • Neoplasms
  • Thromboembolism

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Holmes, H. M., Bain, K. T., Zalpour, A., Luo, R., Bruera, E., & Goodwin, J. (2010). Predictors of anticoagulation in hospice patients with lung cancer. Cancer, 116(20), 4817-4824. https://doi.org/10.1002/cncr.25284

Predictors of anticoagulation in hospice patients with lung cancer. / Holmes, Holly M.; Bain, Kevin T.; Zalpour, Ali; Luo, Ruili; Bruera, Eduardo; Goodwin, James.

In: Cancer, Vol. 116, No. 20, 2010, p. 4817-4824.

Research output: Contribution to journalArticle

Holmes, HM, Bain, KT, Zalpour, A, Luo, R, Bruera, E & Goodwin, J 2010, 'Predictors of anticoagulation in hospice patients with lung cancer', Cancer, vol. 116, no. 20, pp. 4817-4824. https://doi.org/10.1002/cncr.25284
Holmes, Holly M. ; Bain, Kevin T. ; Zalpour, Ali ; Luo, Ruili ; Bruera, Eduardo ; Goodwin, James. / Predictors of anticoagulation in hospice patients with lung cancer. In: Cancer. 2010 ; Vol. 116, No. 20. pp. 4817-4824.
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