Risk of Depression after Venous Thromboembolism in Patients with Hematological Cancer: A Population-Based Cohort Study.

IF 5 2区医学 Q1 HEMATOLOGY Thrombosis and haemostasis Pub Date : 2025-03-01 Epub Date: 2023-12-11 DOI:10.1055/a-2225-5428

Daniel Steiner, Erzsébet Horváth-Puhó, Helle Jørgensen, Kristina Laugesen, Cihan Ay, Henrik Toft Sørensen

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Abstract

Background: Venous thromboembolism (VTE) may complicate the clinical course of cancer patients and add to their psychological burden.

Objectives: We aimed to investigate the association between VTE and risk of subsequent depression in patients with hematological cancer.

Patients and methods: We conducted a population-based cohort study using Danish national health registries. Between 1995 and 2020, we identified 1,190 patients with hematological cancer and incident VTE diagnosed within 6 months before to 1 year after cancer diagnosis. A comparison cohort of patients with hematological cancer without VTE (n = 5,325) was matched by sex, year of birth, cancer type, and year of cancer diagnosis. Patients were followed until diagnosis of depression, emigration, death, study end (2021), or for a maximum of 3 years. Depression was defined as hospital discharge diagnosis of depression or ≥1 prescription for antidepressants. Absolute risks of depression were computed with cumulative incidence functions, treating death as competing event. Hazard ratios (HRs) with 95% confidence intervals (CIs) were computed using Cox proportional hazards regression models, adjusting for comorbidities.

Results: Depression was observed in 158 hematological cancer patients with and 585 without VTE. The 3-year absolute risks of depression were 13.3% (95% CI: 11.5-15.3%) in the VTE cancer cohort and 11.1% (95% CI: 10.3-12.0%) in the comparison cancer cohort, corresponding to a risk difference of 2.2% (95% CI: -1.8-6.5%). VTE was associated with an increased relative risk of depression (adjusted HR: 1.56, 95% CI: 1.28-1.90).

Conclusion: VTE was associated with an elevated risk of subsequent depression in patients with hematological cancer.

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血液肿瘤患者静脉血栓栓塞后抑郁的风险：一项基于人群的队列研究。

背景静脉血栓栓塞（VTE）可能会使癌症患者的临床病程复杂化，并加重他们的心理负担。目的我们旨在研究血液肿瘤患者 VTE 与后续抑郁风险之间的关系。患者和方法我们利用丹麦国家健康登记处开展了一项基于人群的队列研究。从 1995 年到 2020 年，我们共发现了 1,190 名血液肿瘤患者，这些患者在癌症确诊前六个月到确诊后一年内发生了 VTE。我们还根据性别、出生年份、癌症类型和癌症诊断年份，将未发生 VTE 的血液肿瘤患者（人数=5,325）组成了一个对比队列。对患者进行随访，直至确诊抑郁症、移民、死亡、研究结束（2021 年）或最长 3 年。抑郁症的定义是出院诊断为抑郁症或处方抗抑郁药≥1次。抑郁症的绝对风险采用累积发病率函数计算，将死亡作为竞争事件处理。在对合并症进行调整后，使用 Cox 比例危险回归模型计算出危险比 (HR) 和 95% 置信区间 (CI)。结果在158名患有VTE的血液肿瘤患者和585名未患有VTE的患者中观察到抑郁症。VTE癌症队列中抑郁症的3年绝对风险为13.3%（95% CI，11.5%-15.3%），对比癌症队列中抑郁症的3年绝对风险为11.1%（95% CI，10.3%-12.0%），风险差异为2.2%（95% CI，-1.8%-6.5%）。VTE 与抑郁症相对风险增加有关（调整后 HR，1.56，95% CI，1.28-1.90）。结论 VTE 与血液肿瘤患者后续抑郁风险升高有关。

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来源期刊

Thrombosis and haemostasis 医学-外周血管病

CiteScore

11.90

自引率

9.00%

发文量

140

审稿时长

1 months

期刊介绍： Thrombosis and Haemostasis publishes reports on basic, translational and clinical research dedicated to novel results and highest quality in any area of thrombosis and haemostasis, vascular biology and medicine, inflammation and infection, platelet and leukocyte biology, from genetic, molecular & cellular studies, diagnostic, therapeutic & preventative studies to high-level translational and clinical research. The journal provides position and guideline papers, state-of-the-art papers, expert analysis and commentaries, and dedicated theme issues covering recent developments and key topics in the field.