| Autor: |
Au C; Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Gupta E; Division of Pulmonary and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA. enagupta8@gmail.com.; Division of Pulmonary and Critical Care Medicine, Einstein Medical Center, 5501 Old York Road, Philadelphia, PA, 19141, USA. enagupta8@gmail.com., Khaing P; Division of Pulmonary and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Dibello J; Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Chengsupanimit T; Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Mitchell EP; Sidney Kimmel Cancer Center at Thomas Jefferson University Hospital, Philadelphia, PA, USA., West FM; Division of Pulmonary and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Baram M; Division of Pulmonary and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Awsare BK; Division of Pulmonary and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA., Kane GC; Division of Pulmonary and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA. |
| Abstrakt: |
To study whether a diagnosis of cancer affects the clinical presentation and outcomes of patients with pulmonary embolism (PE). A retrospective analysis was performed of all consecutive patients diagnosed with PE on a computed tomography scan from 2014 to 2016 at an urban tertiary-referral medical center. Baseline characteristics, treatment decisions, and mortality data were compared between study subjects with and without a known diagnosis of active cancer. There were 581 subjects, of which 187 (33.0%) had a diagnosis of cancer. On average, cancer subjects tended to be older (64.8 vs. 58.5 years, p < 0.01), had lower body mass index (BMI) (29.0 vs. 31.5 kg/m 2 , p = 0.01), and were less likely to be active smokers (9.2% vs. 21.1%, p < 0.01), as compared to non-cancer subjects. Cancer subjects were also less likely to present with chest pain (18.2% vs. 37.4%, p < 0.01), syncope (2.7% vs. 6.6%, p = 0.05), bilateral PEs (50% vs. 60%, p = 0.025), and evidence of right heart strain (48% vs. 58%, p = 0.024). There was no difference in-hospital length of stay (8.9 vs. 9.4 days, p = 0.61) or rate of intensive care unit (ICU) admission (31.9% vs. 33.3%, p = 0.75) between the two groups. Presence of cancer increased the risk of all-cause one-year mortality (adjusted HR 9.7, 95% CI 4.8-19.7, p < 0.01); however, it did not independently affect in-hospital mortality (adjusted HR 2.9, 95% CI 0.86-9.87, p = 0.086). Patients with malignancy generally presented with less severe PE. In addition, malignancy did not independently increase the risk of in-hospital mortality among PE patients. |
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