使用阿哌沙班治疗的患有静脉血栓栓塞 (VTE) 的癌症患者出血的发生率和危险因素很少被描述。我们分析了前瞻性 CAP 研究的数据，其中 298 名患有任何类型 VTE 的癌症患者每天两次接受 5 毫克阿哌沙班，为期 6 个月。然后每天两次 2.5 毫克阿哌沙班，持续 30 个月。对于大多数分析，大出血和临床相关非大出血被合并为“临床相关出血”。危险因素通过优势比 (OR) 和 95% 置信区间 (CI) 进行评估。治疗前 6 个月期间，临床相关出血的发生率为每人每年 38%，从 7 至 12 个月，每人每年发生率为 21%， 13 至 36 个月期间每人每年 4% 至 8% 之间。临床相关出血与女性年龄超过 74 岁（OR 2.0，95% CI 1.0-4.1）、BMI 低于 21.7（OR 2.3，95% CI 1.1-4.8）以及基线时血红蛋白低于 10.5（OR 2.8，95）相关。前 6 个月内，男性的 % CI 1.1-7.3）和 11.1（OR 3.3，95% CI 1.3-8.4）。与其他癌症相比，胃肠道 (GI) 或泌尿生殖系统癌症与临床相关出血无关。在腔内胃肠道癌患者中，与切除的胃肠道癌相比，未切除的癌症出血风险增加（OR 3.4，95% CI 1.0-11.6）。当患者服用低剂量阿哌沙班时，出血很少。与接受全剂量阿哌沙班治疗的患者出血相关的因素包括高龄、低BMI和低血红蛋白，以及可能未切除的腔内胃肠道癌。Thieme。版权所有。

Incidence of and risk factors for bleeding in cancer patients with venous thromboembolism (VTE) treated with apixaban are poorly described.We analyzed data from the prospective CAP study where 298 cancer patients with any type of VTE received 5 mg apixaban twice daily for 6 months, and then 2.5 mg apixaban twice daily for 30 months. For most analyses major bleedings and clinically relevant non-major bleedings were merged to "clinically relevant bleedings". Risk factors were estimated by odds ratios (OR) and 95% confidence intervals (CI).The incidence of clinically relevant bleedings was 38% per person year during the first 6 months of treatment, 21% per person year from 7 to 12 months, and between 4% and 8% per person year from 13 to 36 months. Clinically relevant bleedings were associated with age above 74 years (OR 2.0, 95% CI 1.0-4.1), BMI below 21.7 (OR 2.3, 95% CI 1.1-4.8), and hemoglobin at baseline below 10.5 for females (OR 2.8, 95% CI 1.1-7.3) and 11.1 for males (OR 3.3, 95% CI 1.3-8.4) during the first 6 months. Gastrointestinal (GI) or urogenital cancer were not associated with clinically relevant bleedings compared with other cancers. Among patients with luminal GI-cancer, non-resected cancer had increased risk of bleeding (OR 3.4, 95% CI 1.0-11.6) compared with resected GI-cancer.It was very few bleedings while patients were on low-dose apixaban. Factors associated with bleeding in patients treated with full-dose apixaban were high age, low BMI, and low hemoglobin, and probably non-resected luminal GI-cancer.Thieme. All rights reserved.