Background Venous thromboembolisms (VTE’s) are the second leading cause of death in cancer patients. While previous analyses have demonstrated VTE rates are greater in GBM patients using smaller patient cohorts in high-grade glioma, since the release of the update 5th edition of the World Health Organization (WHO) classification a systematic analysis in a large-scale cohort of patients with IDH-wildtype GBM with clinical outcomes is lacking.

Methods This study utilizes the online database, TriNetx, to build patient cohorts for outcomes analysis. TriNetX is a database comprised of over 50 healthcare organization patient information that is quarriable by CPT, ICD, RxNorm, and other proprietary codes. Patient cohort demographics were used for propensity score matching. Risk ratios, odds ratios, hazard ratios, and Kaplan Meier curves were utilized for primary outcomes including survival and time-to-event analyses.

Results 24% of patients with GBM experienced at least 1 VTE or PE after their diagnosis. Compared to a population of patients with no cancer history with an index event of an inpatient visit, patients with GBM were at 20.4 (12.23-34.17) and 5.96 (3.85-9.23) times higher risk of experiencing a VTE/PE at 1- and 5-year follow-up, respectively. Sex differences were not seen between VTE/PE rates and survival after VTE/PE at 1- and 5-year follow-up (p>0.05). Lastly, patients with GBM and a VTE/PE after diagnosis experienced worse survival at 1- and 5-year follow-up compared to those without a VTE/PE (p<0.0001 and p = 0.0014, respectively).

Conclusions Patients with GBM experience increased risks of thrombotic events after diagnosis. These risks are not sex-dependent but do affect overall survival.

The author declare no conflicts of interest. JDL is listed as an inventor on intellectual property related to cancer therapies, but this is not directly relevant to this work.

This work is supported by a cancer biology training grant NIH T32 CA059366 (To ARS), Ruth L. Kirschstein Postdoctoral NRSA NIH F32 CA287655 (To ARS), and the Midwest Brain Tumor Foundation Postdoctoral Fellowship (To ARS), NIH HL158801 (to SJC). This work was also supported by the Lerner Research Institute (SJC, JDL) and Case Comprehensive Cancer Center (JDL)

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

We leveraged the Research USA Minimal Date Shift network in the TriNetX platform composed of aggregated, de-identified electronic health record data of 93 million from various healthcare organizations (HCOs) nationwide. Data is available at: https://trinetx.com/solutions/real-world-datasets/#s_0

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All data produced in the present study are available upon reasonable request to the authors