Table 3.
A multivariable cause-specific Cox regression on the risk of an incident tumoural lesion diagnosis, among OAC users, stratified by site-specific bleeding and tumoural lesion
| Hazard ratio | Gastrointestinal tumoural lesion | Tumoural lesion In respiratory tract | Intracranial tumoural lesion | Tumoural lesion in urological tract |
|---|---|---|---|---|
| aHR (95% CI) | aHR (95% CI) | aHR (95% CI) | aHR (95% CI) | |
| Local bleeding event | ||||
| Bleeding after OAC initiation | 8.13 (7.08–9.34) | 4.91 (3.24–7.44) | 27.89 (16.53–47.04) | 12.73 (10.56–15.35) |
| Type of OAC related to bleeding (ref = VKA) | ||||
| NOAC-related bleeding | 1.04 (0.89–1.21) | 2.11 (1.31–3.40) | 0.84 (0.45–1.55) | 0.93 (0.76–1.14) |
| Demographics | ||||
| Age | 1.02 (1.02–1.03) | 1.02 (1.02–1.03) | 1.01 (0.99–1.02) | 1.06 (1.05–1.06) |
| Sex | 0.78 (0.73–0.83) | 0.46 (0.40–0.52) | 0.78 (0.6–1.02) | 0.20 (0.18–0.22) |
| Comorbidities | ||||
| Hypertension | 0.95 (0.88–1.02) | 0.84 (0.74–0.96) | 1.04 (0.79–1.36) | 0.98 (0.9–1.07) |
| CAD | 0.95 (0.88–1.03) | 0.88 (0.77–1.00) | 0.80 (0.58–1.10) | 1.01 (0.92–1.11) |
| Peripheral artery disease (smoking) | 1.11 (1–1.23) | 1.68 (1.44–1.96) | 1.40 (0.98–2.01) | 1.15 (1.01–1.31) |
| Dyslipidaemia | 1.00 (0.94–1.05) | 0.90 (0.82–0.99) | 1.12 (0.91–1.37) | 1.00 (0.94–1.07) |
| CKD | 0.90 (0.82–1) | 0.82 (0.68–0.99) | 0.68 (0.43–1.07) | 1.08 (0.96–1.21) |
| Chronic liver disease | 1.14 (0.97–1.35) | 0.82 (0.55–1.22) | 0.78 (0.35–1.74) | 0.87 (0.68–1.11) |
| Chronic lung disease | 1.25 (1.16–1.34) | 1.87 (1.66–2.09) | 1.55 (1.17–2.06) | 1.07 (0.98–1.18) |
| Pneumonia | 1.04 (0.92–1.17) | 1.48 (1.24–1.77) | 1.12 (0.66–1.89) | 0.93 (0.78–1.11) |
| Upper GI tract disordera | 1.10 (1.00–1.22) | 0.86 (0.72–1.03) | 0.77 (0.48–1.23) | 0.9 (0.78–1.03) |
| Lower GI tract disorderb | 1.35 (1.23–1.49) | 0.92 (0.76–1.11) | 1.00 (0.65–1.54) | 1.05 (0.92–1.2) |
| Inflammatory bowel disease | 1.07 (0.72–1.60) | 0.73 (0.37–1.45) | 1.22 (0.29–5.11) | 1.40 (0.76–2.58) |
| Diabetes mellitus | 1.10 (1.03–1.18) | 0.85 (0.75–0.96) | 0.83 (0.63–1.09) | 1.00 (0.91–1.09) |
| Anaemia | 1.07 (0.96–1.20) | 0.90 (0.75–1.09) | 1.39 (0.90–2.13) | 1.02 (0.88–1.17) |
| Risk scores | ||||
| CCI | 0.98 (0.95–1.02) | 1.05 (0.99–1.11) | 1.03 (0.90–1.17) | 0.99 (0.95–1.03) |
| CHA2DS2-VASc score | 1.00 (0.96–1.03) | 0.95 (0.89–1.02) | 0.97 (0.82–1.15) | 0.97 (0.92–1.02) |
| Frailty score | 0.24 (0.18–0.33) | 0.29 (0.17–0.50) | 0.18 (0.05–0.63) | 0.40 (0.28–0.58) |
| HAS-BLED score | 1.04 (1.00–1.09) | 1.13 (1.05–1.21) | 1.03 (0.88–1.22) | 1.03 (0.98–1.09) |
| Medication usage | ||||
| Drug number at baseline | 1.02 (1.01–1.02) | 1.03 (1.02–1.05) | 1.00 (0.97–1.03) | 1.03 (1.01–1.04) |
| NSAID | 0.98 (0.92–1.04) | 0.88 (0.79–0.97) | 0.95 (0.75–1.20) | 0.97 (0.90–1.05) |
CCI, Charlson comorbidity index; CRNMB, clinically relevant non-major bleeding; MB, major bleeding; NOAC, non-vitamin K antagonist oral anticoagulant; NSAID, non-steroidal anti-inflammatory drug; OAC, oral anticoagulant; SE, systemic embolism; VKA, vitamin K antagonist.
aUpper gastrointestinal tract disorders were defined as gastroesophageal reflux diseases or peptic ulcer disease.
bLower gastrointestinal tract disorder was defined as diverticulosis, angiodysplasia, colorectal polyposis, or haemorrhoids.