INCIDENCE OF AND RISK FACTORS FOR MAJOR HEMORRHAGE IN US VETERANS ADMINISTRATION PATIENTS WITH NEWLY DIAGNOSED CHRONIC LYMPHOCYTIC LEUKEMIA
(Abstract release date: 05/19/16)
EHA Library. Georgantopolous P. 06/09/16; 132629; E1080
Mr. Peter Georgantopolous
Contributions
Contributions
Abstract
Abstract: E1080
Type: Eposter Presentation
Background
Patients with chronic lymphocytic leukemia (CLL) have an increased risk for major hemorrhage (MH) compared to the age- and gender-matched general population (Gifkins et al, Blood, 2015). However, the specific risk factors associated with bleeding among patients with CLL are not well established.
Aims
Our objective was to estimate the incidence of MH among patients newly diagnosed with CLL receiving care at US Veterans Administration (VA) healthcare facilities and to identify risk factors associated with MH in these patients.
Methods
Patients diagnosed with CLL from 1999 through 2013 were identified using ICD-9 codes from VA electronic medical records. Those with <6 months of VA care before CLL diagnosis were excluded from analysis to capture a newly diagnosed patient cohort. Follow-up was from initial CLL diagnosis until death, 12/31/2013, or MH onset, whichever occurred first. We defined an MH event as a diagnosis code of bleeding in a critical area or organ or bleeding that was treated with blood transfusion within 7 days. We calculated the incidence rate of MH after CLL diagnosis. Potential risk factors included demographic characteristics and selected medical history based on ICD-9 codes within 6 months before the first CLL diagnostic code. We performed univariate comparisons and a backward stepwise Cox proportional hazards regression analysis.
Results
Of the 24,581 veterans with newly diagnosed CLL, 24,166 (98.3%) were male, 20,464 (83.3%) were white; median age at diagnosis was 72.0 years; 2,013 (8.2%) experienced MH after CLL diagnosis, with a median time of 2.6 years between diagnosis and MH event. The incidence of MH was 16.4 per 1,000 person-years (95% CI, 15.7-17.1/1000). Statistically significant (P<0.05) risk factors for MH were (HR; 95% CI) history of MH (4.0; 3.4-4.7), anemia (2.6; 2.0-3.4), stroke (2.0; 1.2-3.5), male (2.0; 1.3-3.0), African American (1.7 vs white race; 1.5-2.0), uncontrolled hypertension (1.7; 1.3-2.2), atrial fibrillation (1.5; 1.2-1.7), CAD (1.3; 1.1-1.4), and age >75 years (1.1 vs <65 years; 1.0-1.3).
Conclusion
The incidence of MH in newly diagnosed CLL patients was 16.4 per 1,000 person-years. Risk factors most strongly associated with MH after CLL diagnosis are history of MH, anemia, stroke, and being male.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Hemorrhage, Incidence, Risk factor
Type: Eposter Presentation
Background
Patients with chronic lymphocytic leukemia (CLL) have an increased risk for major hemorrhage (MH) compared to the age- and gender-matched general population (Gifkins et al, Blood, 2015). However, the specific risk factors associated with bleeding among patients with CLL are not well established.
Aims
Our objective was to estimate the incidence of MH among patients newly diagnosed with CLL receiving care at US Veterans Administration (VA) healthcare facilities and to identify risk factors associated with MH in these patients.
Methods
Patients diagnosed with CLL from 1999 through 2013 were identified using ICD-9 codes from VA electronic medical records. Those with <6 months of VA care before CLL diagnosis were excluded from analysis to capture a newly diagnosed patient cohort. Follow-up was from initial CLL diagnosis until death, 12/31/2013, or MH onset, whichever occurred first. We defined an MH event as a diagnosis code of bleeding in a critical area or organ or bleeding that was treated with blood transfusion within 7 days. We calculated the incidence rate of MH after CLL diagnosis. Potential risk factors included demographic characteristics and selected medical history based on ICD-9 codes within 6 months before the first CLL diagnostic code. We performed univariate comparisons and a backward stepwise Cox proportional hazards regression analysis.
Results
Of the 24,581 veterans with newly diagnosed CLL, 24,166 (98.3%) were male, 20,464 (83.3%) were white; median age at diagnosis was 72.0 years; 2,013 (8.2%) experienced MH after CLL diagnosis, with a median time of 2.6 years between diagnosis and MH event. The incidence of MH was 16.4 per 1,000 person-years (95% CI, 15.7-17.1/1000). Statistically significant (P<0.05) risk factors for MH were (HR; 95% CI) history of MH (4.0; 3.4-4.7), anemia (2.6; 2.0-3.4), stroke (2.0; 1.2-3.5), male (2.0; 1.3-3.0), African American (1.7 vs white race; 1.5-2.0), uncontrolled hypertension (1.7; 1.3-2.2), atrial fibrillation (1.5; 1.2-1.7), CAD (1.3; 1.1-1.4), and age >75 years (1.1 vs <65 years; 1.0-1.3).
Conclusion
The incidence of MH in newly diagnosed CLL patients was 16.4 per 1,000 person-years. Risk factors most strongly associated with MH after CLL diagnosis are history of MH, anemia, stroke, and being male.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Hemorrhage, Incidence, Risk factor
Abstract: E1080
Type: Eposter Presentation
Background
Patients with chronic lymphocytic leukemia (CLL) have an increased risk for major hemorrhage (MH) compared to the age- and gender-matched general population (Gifkins et al, Blood, 2015). However, the specific risk factors associated with bleeding among patients with CLL are not well established.
Aims
Our objective was to estimate the incidence of MH among patients newly diagnosed with CLL receiving care at US Veterans Administration (VA) healthcare facilities and to identify risk factors associated with MH in these patients.
Methods
Patients diagnosed with CLL from 1999 through 2013 were identified using ICD-9 codes from VA electronic medical records. Those with <6 months of VA care before CLL diagnosis were excluded from analysis to capture a newly diagnosed patient cohort. Follow-up was from initial CLL diagnosis until death, 12/31/2013, or MH onset, whichever occurred first. We defined an MH event as a diagnosis code of bleeding in a critical area or organ or bleeding that was treated with blood transfusion within 7 days. We calculated the incidence rate of MH after CLL diagnosis. Potential risk factors included demographic characteristics and selected medical history based on ICD-9 codes within 6 months before the first CLL diagnostic code. We performed univariate comparisons and a backward stepwise Cox proportional hazards regression analysis.
Results
Of the 24,581 veterans with newly diagnosed CLL, 24,166 (98.3%) were male, 20,464 (83.3%) were white; median age at diagnosis was 72.0 years; 2,013 (8.2%) experienced MH after CLL diagnosis, with a median time of 2.6 years between diagnosis and MH event. The incidence of MH was 16.4 per 1,000 person-years (95% CI, 15.7-17.1/1000). Statistically significant (P<0.05) risk factors for MH were (HR; 95% CI) history of MH (4.0; 3.4-4.7), anemia (2.6; 2.0-3.4), stroke (2.0; 1.2-3.5), male (2.0; 1.3-3.0), African American (1.7 vs white race; 1.5-2.0), uncontrolled hypertension (1.7; 1.3-2.2), atrial fibrillation (1.5; 1.2-1.7), CAD (1.3; 1.1-1.4), and age >75 years (1.1 vs <65 years; 1.0-1.3).
Conclusion
The incidence of MH in newly diagnosed CLL patients was 16.4 per 1,000 person-years. Risk factors most strongly associated with MH after CLL diagnosis are history of MH, anemia, stroke, and being male.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Hemorrhage, Incidence, Risk factor
Type: Eposter Presentation
Background
Patients with chronic lymphocytic leukemia (CLL) have an increased risk for major hemorrhage (MH) compared to the age- and gender-matched general population (Gifkins et al, Blood, 2015). However, the specific risk factors associated with bleeding among patients with CLL are not well established.
Aims
Our objective was to estimate the incidence of MH among patients newly diagnosed with CLL receiving care at US Veterans Administration (VA) healthcare facilities and to identify risk factors associated with MH in these patients.
Methods
Patients diagnosed with CLL from 1999 through 2013 were identified using ICD-9 codes from VA electronic medical records. Those with <6 months of VA care before CLL diagnosis were excluded from analysis to capture a newly diagnosed patient cohort. Follow-up was from initial CLL diagnosis until death, 12/31/2013, or MH onset, whichever occurred first. We defined an MH event as a diagnosis code of bleeding in a critical area or organ or bleeding that was treated with blood transfusion within 7 days. We calculated the incidence rate of MH after CLL diagnosis. Potential risk factors included demographic characteristics and selected medical history based on ICD-9 codes within 6 months before the first CLL diagnostic code. We performed univariate comparisons and a backward stepwise Cox proportional hazards regression analysis.
Results
Of the 24,581 veterans with newly diagnosed CLL, 24,166 (98.3%) were male, 20,464 (83.3%) were white; median age at diagnosis was 72.0 years; 2,013 (8.2%) experienced MH after CLL diagnosis, with a median time of 2.6 years between diagnosis and MH event. The incidence of MH was 16.4 per 1,000 person-years (95% CI, 15.7-17.1/1000). Statistically significant (P<0.05) risk factors for MH were (HR; 95% CI) history of MH (4.0; 3.4-4.7), anemia (2.6; 2.0-3.4), stroke (2.0; 1.2-3.5), male (2.0; 1.3-3.0), African American (1.7 vs white race; 1.5-2.0), uncontrolled hypertension (1.7; 1.3-2.2), atrial fibrillation (1.5; 1.2-1.7), CAD (1.3; 1.1-1.4), and age >75 years (1.1 vs <65 years; 1.0-1.3).
Conclusion
The incidence of MH in newly diagnosed CLL patients was 16.4 per 1,000 person-years. Risk factors most strongly associated with MH after CLL diagnosis are history of MH, anemia, stroke, and being male.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Hemorrhage, Incidence, Risk factor
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