HIDDEN2: a prospective longitudinal observational study of the prevalence of deep vein thrombosis in patients with cancer receiving palliative care upon admission to hospital

Noble, Simon ORCID: https://orcid.org/0000-0001-5425-2383, Alikhan, Raza, Bryant, Catherine, Groves, Tristan, Harding, Elin, Kitson, Terri ORCID: https://orcid.org/0000-0001-6333-046X, Pease, Nikki Jane, Raisanen, Lawrence, Seddon, Kathy, Smith, Deb, Smith, Joanna, Thomas, Ian, Upton, Laura, Walker, Sarah, Wallace, Rebecca and Casbard, Angela 2026. HIDDEN2: a prospective longitudinal observational study of the prevalence of deep vein thrombosis in patients with cancer receiving palliative care upon admission to hospital. BMJ Supportive & Palliative Care 10.1136/spcare-2026-006653

PDF - Published Version Available under License Creative Commons Attribution. Download (412kB)

Abstract

Objectives Previous research has demonstrated a 28% prevalence of deep vein thrombosis (DVT) in hospice patients with advanced cancer, challenging the utility of thromboprophylaxis in palliative care. It is unknown whether these data can be applied to patients with cancer receiving palliative care admitted to the acute hospital setting. Methods Prospective longitudinal observational study in three acute hospitals. Consecutive adults with cancer receiving palliative care underwent bilateral leg colour duplex ultrasonography for proximal DVT. Associations with demographics and clinical outcomes, including new venous thromboembolism (VTE) at 90 days were identified. Results 207 adults with cancer who were receiving palliative care were recruited (mean age 66.7 (SD 12.1), range 36–90 years; men 46.9%). Mean Australia-modified Karnofsky Performance Scale was 61.2 (SD 16.1, range 30–90) and median survival was 122 days, IQR (50–203). Acute DVT was present in 1 (0.56%) of 180 evaluable scans, with 4 (2.2%) demonstrating chronic/post-thrombotic changes. Nine patients (4.3%) were diagnosed with VTE within 90 days of registration. These comprised six DVT, pulmonary embolus (PE) or PE/DVT and three elsewhere (renal vein or mesenteric vessels). Of these five (55.6%) were symptomatic and four (44.4%) incidental. Conclusions The prevalence of DVT in palliative care patients admitted acutely to hospital is considerably lower than those admitted to the hospice. This suggests a different phenotype to those admitted to the hospice and represents a patient group that should be considered for thromboprophylaxis on an individualised basis.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine Research Institutes & Centres > Centre for Trials Research (CNTRR)
Publisher:	BMJ Publishing Group
ISSN:	2045-435X
Date of First Compliant Deposit:	5 November 2026
Date of Acceptance:	25 September 2026
Last Modified:	05 Nov 2026 12:15
URI:	https://orca.cardiff.ac.uk/id/eprint/190693

Actions (repository staff only)

Edit Item