Abstract
The study aimed to identify predictors of overall 30-day mortality in cancer patients with pulmonary embolism including suspected pulmonary embolism (SPE) and unsuspected pulmonary embolism (UPE) events. Secondary outcomes included 30- and 90-day major bleeding and venous thromboembolism (VTE) recurrence.
The study cohort included 1033 consecutive patients with pulmonary embolism from the multicentre observational ambispective EPIPHANY study (March 2006–October 2014). A subgroup of 497 patients prospectively assessed for the study were subclassified into three work-up scenarios (SPE, truly asymptomatic UPE and UPE with symptoms) to assess outcomes.
The overall 30-day mortality rate was 14%. The following variables were associated with the overall 30-day mortality on multivariate analysis: VTE history, upper gastrointestinal cancers, metastatic disease, cancer progression, performance status, arterial hypotension <100 mmHg, heart rate >110 beats·min−1, basal oxygen saturation <90% and SPE (versus overall UPE).
The overall 30-day mortality was significantly lower in patients with truly asymptomatic UPE events (3%) compared with those with UPE-S (20%) and SPE (21%) (p<0.0001). Thirty- and 90-day VTE recurrence and major bleeding rates were similar in all the groups.
In conclusion, variables associated with the severity of cancer and pulmonary embolism were associated with short-term mortality. Our findings may help to develop pulmonary embolism risk-assessment models in this setting.
Abstract
Predictors of 30-day mortality in cancer patients with suspected and unsuspected pulmonary embolism http://ow.ly/Nu0k305t5KD
Footnotes
This article has supplementary material available from erj.ersjournals.com
LEO Pharma Spain provided funding for the study via an academic grant. Funding information for this article has been deposited with the Open Funder Registry.
Conflict of interest: None declared.
- Received February 6, 2016.
- Accepted October 13, 2016.
- Copyright ©ERS 2017