{
  "abstract": "Background\n\nThe Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is central to cancer care planning and prognostication. Whether ECOG-PS also carries prognostic value in the setting of primary thromboprophylaxis for cancer-associated venous thromboembolism (VTE) remains unknown.Objectives\n\nTo evaluate the impact of ECOG-PS on clinical outcomes in ambulatory patients with cancer initiating chemotherapy.Methods\n\nThis was a post-hoc analysis of the AVERT randomized controlled trial that evaluated apixaban (2.5 mg twice daily) for thromboprophylaxis in patients at intermediate-to-high VTE risk. Multivariable survival models assessed the association between ECOG-PS (0-1 versus 2-3) and the composite primary outcome of VTE or clinically relevant bleeding (CRB), as well as its individual components and all-cause mortality, over 180 days.Results\n\nOf 428 patients included, 368 (86.0%) and 60 (14.0%) had an ECOG-PS of 0-1 and 2-3, respectively. The primary composite outcome occurred in 12.8% (n = 47) in those with ECOG 0-1 and 18.3% (n = 11) with ECOG-PS 2-3 (6-month cumulative incidence: 13.0% [95% CI: 9.8%-16.7%] versus 19.9% [95% CI: 10.5%-31.4%], respectively). Worse performance status was associated with higher risks for the composite outcome (aHR: 1.76; 95% CI: 1.14-2.72; p = 0.011), CRB (aHR: 1.58; 95%CI: 1.53-1.63; p < 0.0001), and all-cause mortality (aHR: 5.77; 95% CI: 4.98-6.67; p < 0.0001). In exploratory treatment-effect analyses, apixaban reduced VTE risk across ECOG-PS strata, including among participants with ECOG-PS 2-3, without clear evidence of excess CRB in this subgroup.Conclusions\n\nECOG-PS predicts VTE-related outcomes in ambulatory patients with cancer and may inform individualized, value-based shared decision-making regarding anticoagulant thromboprophylaxis.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.",
    "Ottawa Methods Center, Ottawa Ottawa Hospital Research Institute, Ottawa, ON, Canada.",
    "Sault Area Hospital, Sault Ste. Marie, Canada.",
    "London Health Sciences Centre, London, Canada.",
    "Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada.",
    "Department of Medicine, Nova Scotia Health, Dalhousie University, Halifax, NS, Canada.",
    "Department of Medicine and Ageing Sciences, Gabriele D'Annunzio University, Chieti, Italy.",
    "Department of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. mcarrier@toh.ca.",
    "Inflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. mcarrier@toh.ca.",
    "Division of Hematology, Department of Medicine, The Ottawa Hospital General Campus, Box 201a, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. mcarrier@toh.ca."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nicola Potere"
    },
    {
      "affs": [
        0
      ],
      "name": "Yan Xu"
    },
    {
      "affs": [
        1
      ],
      "name": "Ranjeeta Mallick"
    },
    {
      "affs": [
        0
      ],
      "name": "Tzu-Fei Wang"
    },
    {
      "affs": [
        2
      ],
      "name": "Danny Hill"
    },
    {
      "affs": [
        3
      ],
      "name": "Alejandro Lazo-Langner"
    },
    {
      "affs": [
        4
      ],
      "name": "Vicky Tagalakis"
    },
    {
      "affs": [
        5
      ],
      "name": "Sudeep Shivakumar"
    },
    {
      "affs": [
        6
      ],
      "name": "Marcello Di Nisio"
    },
    {
      "affs": [
        0
      ],
      "name": "Philip S Wells"
    },
    {
      "affs": [
        7,
        8,
        9
      ],
      "name": "Marc Carrier"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4hyd1hc5fexn7.bib",
  "cited_by": 0,
  "doi": "10.1186/s40959-026-00542-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13679223",
  "id": "4hyd1hc5fexn7",
  "issns": [
    "2057-3804"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897686",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7170049373",
  "pdf_url": "https://europepmc.org/articles/PMC13679223?pdf=render",
  "pmcid": "PMC13679223",
  "pmid": "42897686",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/4hyd1hc5fexn7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:42Z",
      "native_id": "MED:42897686",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897686"
    },
    {
      "first_seen": "2026-10-30T13:46:34Z",
      "native_id": "7f23cd543e584c6c855b8c91f07b5815",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s40959-026-00542-7"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    },
    {
      "field": "medicine",
      "origin": "lcc:RC254-282",
      "subfield": "oncology"
    }
  ],
  "title": "Performance status and outcomes in patients with cancer receiving thromboprophylaxis: a subanalysis of the AVERT trial.",
  "title_text": "Performance status and outcomes in patients with cancer receiving thromboprophylaxis: a subanalysis of the AVERT trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:34Z",
  "url": "https://research.draconitic.com/paper/4hyd1hc5fexn7",
  "venue": "Cardio-oncology (London, England)",
  "versions": []
}