Observational studyThe Lancet. Haematology2019
Prevalence, symptom burden, and natural history of deep vein thrombosis in people with advanced cancer in specialist palliative care units (HIDDen): a prospective longitudinal observational study.
Observational study in The Lancet. Haematology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 85 citations in OpenAlex.
- American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer.Blood advances · 2021Guideline
- Establishment and Validation of a Postoperative VTE Prediction Model in Patients with Colorectal Cancer Undergoing Radical Resection: CRSPOT Nomogram.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisTrial
- Discontinuation of Anticoagulants and Occurrence of Bleeding and Thromboembolic Events in Vitamin K Antagonist Users with a Life-Limiting Disease.Thrombosis and haemostasis · 2026Article
- The coagulation-inflammation axis in advanced cancer: associations with cardiovascular-thrombotic complications.Journal of thrombosis and thrombolysis · 2026Article
- Antithrombotic therapy at the end-of-life-continue or stop?Research and practice in thrombosis and haemostasis · 2026Review
- A Retrospective Analysis of Endovascular Stent Insertion for Malignant Superior Vena Cava Obstruction, Focusing on Anticoagulation Practices.Current oncology (Toronto, Ont.) · 2025Article
- Article
- Urinary metabolite model to predict the dying process in lung cancer patients.Communications medicine · 2025Article
- Anticoagulation at the end of life: whether, when, and how to treat.Hematology. American Society of Hematology. Education Program · 2024Review
- Treatment of VTE in the thrombocytopenic cancer patient.Hematology. American Society of Hematology. Education Program · 2024Review
- Review
- Factors associated with in-hospital and outpatient survival of patients with different types of stage IV cancer and venous thromboembolism.The Journal of international medical research · 2023Article
- HIDDEN2: Study protocol for the hospital deep vein thrombosis detection study in patients with cancer receiving palliative care.BMJ open · 2023Article
- Deep vein thrombosis and validation of the Caprini risk assessment model in Chinese orthopaedic trauma patients: a multi-center retrospective cohort study enrolling 34,893 patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Evaluation of the Use of Anticoagulotherapy in Cancer Patients in Palliative Care Residence.Palliative medicine reports · 2023Article
- Risks, diagnosis, and management of recurrent cancer-associated thrombosis (CAT): a narrative review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Review
- EHA Guidelines on Management of Antithrombotic Treatments in Thrombocytopenic Patients With Cancer.HemaSphere · 2022Article
- Thrombotic complications in patients with cancer: Advances in pathogenesis, prevention, and treatment-A report from ICTHIC 2021.Research and practice in thrombosis and haemostasis · 2022Review
- Risk assessment of thromboembolic events in hospitalized cancer patients.Scientific reports · 2021Observational
- Using the United Kingdom standards for public involvement to evaluate the impact of public involvement in a multinational clinical study.Research involvement and engagement · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundThe prevalence of deep venous thrombosis in patients with advanced cancer is unconfirmed and it is unknown whether current international thromboprophylaxis guidance is applicable to this population. We aimed to determine prevalence and predictors of femoral deep vein thrombosis in patients admitted to specialist palliative care units (SPCUs).
methodsWe did this prospective longitudinal observational study in five SPCUs in England, Wales, and Northern Ireland (four hospices and one palliative care unit). Consecutive adults with cancer underwent bilateral femoral vein ultrasonography on admission and weekly until death or discharge for a maximum of 3 weeks. Data were collected on performance status, attributable symptoms, and variables known to be associated with venous thromboembolism. Patients with a short estimated prognosis (<5 days) were ineligible. The primary endpoint of the study was the prevalence of femoral deep vein thrombosis within 48 h of SPCU admission, analysed by intention to treat. This study is registered with the ISRCTN registry, number ISRCTN97567719.
findingsBetween June 20, 2016, and Oct 16, 2017, 343 participants were enrolled (mean age 68·2 years [SD 12·8; range 25-102]; 179 [52%] male; mean Australian-modified Karnofsky performance status 49 [SD 16·6; range 20-90]). Of 273 patients with evaluable scans, 92 (34%, 95% CI 28-40) had femoral deep vein thrombosis. Four participants with a scan showing no deep vein thrombosis on admission developed a deep vein thrombosis on repeat scanning over 21 days. Previous venous thromboembolism (p=0·014), being bedbound in the past 12 weeks for any reason (p=0·003), and lower limb oedema (p=0·009) independently predicted deep vein thrombosis. Serum albumin concentration (p=0·43), thromboprophylaxis (p=0·17), and survival (p=0·45) were unrelated to deep vein thrombosis.
interpretationAbout a third of patients with advanced cancer admitted to SPCUs had a femoral deep vein thrombosis. Deep vein thrombosis was not associated with thromboprophylaxis, survival, or symptoms other than leg oedema. These findings are consistent with venous thromboembolism being a manifestation of advanced disease rather than a cause of premature death. Thromboprophylaxis for SPCU inpatients with poor performance status seems to be of little benefit.
fundingNational Institute for Health Research (Research for Patient Benefit programme).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.