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Rising prevalence of venous thromboembolism in gastrointestinal cancers: a nationwide analysis of 205 million hospitalizations, 2016–2022
Journal article   Open access   Peer reviewed

Rising prevalence of venous thromboembolism in gastrointestinal cancers: a nationwide analysis of 205 million hospitalizations, 2016–2022

Kuldeepsinh Pradipkumar Atodaria, Arpeet Patel, Niharika Kottapalli, Pratap Tetali, Sabah Iqbal, Samyak Dhruv, Tarun Parvataneni, Steven J. Cohen and Ammar Ashfaq
Journal of gastrointestinal oncology, v 17(3), p=
30 Jun 2026
DOI: https://doi.org/10.21037/jgo-2025-1-999
PMID: 42434252
url
https://doi.org/10.21037/jgo-2025-1-999View
Published, Version of Record (VoR) Open

Abstract

Original
<p>Background: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a well-recognized complication of malignancy, yet comprehensive data on VTE prevalence across all gastrointestinal cancer (GIC) subtypes are lacking. Methods: Using the National Inpatient Sample (NIS) database from 2016 to 2022, we performed a cross-sectional analysis of 205,075,197 adult hospitalizations to quantify the prevalence and temporal trends of DVT, PE and VTE in GIC hospitalizations, and calculated the relative risk (RR) of VTE and inpatient death (IPD) in GICs compared with all hospitalizations. GICs included malignant neoplasms of the esophagus, stomach, small intestine, colon, rectosigmoid junction, rectum, anus and anal canal, liver, intrahepatic bile duct, gallbladder, biliary tract, pancreas, and neuroendocrine tumors. Results: Of 3,663,570 GIC hospitalizations (1.78%), VTE was present in 197,355(5.39%), compared with 2.21% in all hospitalizations [RR =2.44; 95% confidence interval (CI): 2.43-2.45]. Pancreatic cancer had the highest VTE prevalence (8.44%), followed by gallbladder (7.05%) and stomach cancer (6.79%). A statistically significant rising trend in VTE prevalence was observed for GICs (Cochran-Armitage P<0.001), notably beginning before the coronavirus disease 2019 (COVID-19) pandemic, whereas VTE in all hospitalizations remained stable at 2% from 2016 to 2019 before rising sharply in 2020. IPD with VTE in GICs was 11.5%, compared to 7.4% for all hospitalizations with VTE (RR =1.55; 95% CI: 1.53-1.57). VTE in GICs was associated with a 91% higher risk of IPD compared to GIC hospitalizations without VTE (RR =1.91; 95% CI: 1.89-1.94). Conclusions: These findings highlight the elevated and rising VTE burden across GIC subtypes and underscore the importance of VTE risk assessment and prophylaxis in hospitalized GIC patients.</p>

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