Bleeding events largely outnumber thromboembolic events in patients with cancer during the last phase of life, most patients continue antithrombotic therapy

Background: Blood thinners can prevent strokes and blood clots, but they also increase bleeding risk.

It is unclear whether patients with cancer continue to benefit from these medications during the final weeks of life.

Researchers in the Netherlands examined blood thinner use and related events in people with cancer during this period using routine general practitioner (GP) records from 2018 to 2022.

They analysed data from 2,860 adults starting when the GP first registered palliative care and reviewed records until death or their last GP visit (median follow up period was about six weeks).

What They Found: Blood thinners were used by one third of the patients with cancer in the last phase of life.

Only one in five patients discontinued treatment, usually shortly before death, with a median of eight days beforehand.

The most recorded reason was the patient’s recognition of the final stage of life. Bleeding events were common in both groups.

At least one bleeding episode occurred in 28.5% of patients taking blood thinners and in 22.0% of those not taking them.

New blood clots were less common, with venous clots occurring in 3.1% of users and 3.0% of non-users. Arterial events such as stroke or heart attack were recorded in 2.5% and 1.9%, respectively.

Bleeding was markedly under-recorded in diagnosis codes compared with manual review (3.7% coded vs 28.5% manually identified among users).

Implications: These findings provide a detailed picture of antithrombotic management in primary care near the end of life.

Antithrombotic Therapy Discontinuation, Bleeding, and Thromboembolic Events in Patients With Cancer During the Last Phase of Life: Insights From Primary Care  Records 

Article: Bleeding events largely outnumber thromboembolic events in patients with cancer during the l

Source: American Academy of Family Physicians