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Anti‐thrombotic therapy in patients with cancer at the end of life and associated clinical outcomes: A cohort study using population‐linked routinely collected data
Sarah Aldridge,
Ashley Akbari 
,
Adrian Edwards ,
Kate J. Lifford ,
Denise Abbel ,
Suzanne Cannegieter ,
Jamilla Goedegebuur ,
Eva K. Kempers ,
Mette Søgaard ,
Chantal Visser ,
Geert‐Jan Geersing ,
Marieke J. H. Kruip ,
Anne Gulbech Ording ,
Carline van den Dries ,
Eric C. T. Geijteman ,
Erik Klok ,
Isabelle Mahé ,
Simon P. Mooijaart ,
Sebastian Szmit ,
Simon Noble
,
Adrian Edwards ,
Kate J. Lifford ,
Denise Abbel ,
Suzanne Cannegieter ,
Jamilla Goedegebuur ,
Eva K. Kempers ,
Mette Søgaard ,
Chantal Visser ,
Geert‐Jan Geersing ,
Marieke J. H. Kruip ,
Anne Gulbech Ording ,
Carline van den Dries ,
Eric C. T. Geijteman ,
Erik Klok ,
Isabelle Mahé ,
Simon P. Mooijaart ,
Sebastian Szmit ,
Simon Noble
British Journal of Haematology
Swansea University Authors:
Sarah Aldridge, Ashley Akbari
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DOI (Published version): 10.1111/bjh.70032
Abstract
Anti-thrombotic therapy (ATT) in cancer patients approaching the end of life presents significant clinical challenges, balancing thrombotic and bleeding risks. This study analysed ATT prescribing patterns and associated outcomes in patients diagnosed with poor prognosis cancer, defined as cancer dia...
| Published in: | British Journal of Haematology |
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| ISSN: | 0007-1048 1365-2141 |
| Published: |
Wiley
2025
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa69965 |
| Abstract: |
Anti-thrombotic therapy (ATT) in cancer patients approaching the end of life presents significant clinical challenges, balancing thrombotic and bleeding risks. This study analysed ATT prescribing patterns and associated outcomes in patients diagnosed with poor prognosis cancer, defined as cancer diagnoses associated with a 1-year life expectancy, using the Welsh national Secure Anonymised Information Linkage Databank. Retrospective cohort study of adults in Wales diagnosed with poor prognosis cancer between 2013 and 2021, following up patients from cancer diagnosis until death, end of follow-up or study end (31 December 2021). Outcomes included ATT discontinuation, bleeding and thromboembolic events in secondary care. We identified a cohort of 25 783 adults with a median survival of 145 days. Of these, 32% were receiving ATT at diagnosis, with 77% continuing until death. One-year cumulative incidence of ATT discontinuation was 19% (95% CI: 18%–20%). The 1-year cumulative incidence of bleeding was 3.2% (95% CI: 3.0%–3.4%) and of thromboembolic events was 5.3% (95% CI: 5.0%–5.6%). ATT was prevalent at cancer diagnosis and discontinuation before death was uncommon. The management of ATT is complex in patients with advanced cancer and there is a need for clearer guidance on appropriate discontinuation strategies as well as when to continue these medicines. |
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| Keywords: |
anti-coagulants; anti-platelets; anti-thrombotic therapy; cohort study; end of life cancer care; palliative care |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
UK Research and Innovation (Grant Numbers: 10039823, 10038000); HORIZON EUROPE European Innovation Council (Grant Number: 101057292) |