Barca-Hernando Maria, Ortega-Rivera Rocio, Lopez-Ruz Sergio, Elias-Hernandez Teresa, Asensio-Cruz Maria Isabel, Marin-Romero Samira, Toral Javier, Montero Emilio, Sanchez Veronica, Arellano Elena, Sanchez-Diaz Jose Maria, Real-Dominguez Macarena, Otero-Candelera Remedios, Jara-Palomares Luis
Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Cancers (Basel). 2020 Aug 13;12(8):2267. doi: 10.3390/cancers12082267.
In symptomatic acute pulmonary embolism (PE), the presence of deep vein thrombosis (DVT) is a risk factor for 30- and 90-day mortality. In patients with cancer and incidental PE, the prognostic effect of concomitant incidental DVT is unknown. In this retrospective study, we examined the effect of incidental DVT on all-cause mortality in such patients. Adjusted Cox multivariate regression analysis was used for relevant covariates. From January 2010 to March 2018, we included 200 patients (mean age, 65.3 ± 12.4 years) who were followed up for 12.5 months (interquartile range 7.4-19.4 months). Of these patients, 62% had metastases, 31% had concomitant incidental DVT, and 40.1% ( = 81) died during follow-up. All-cause mortality did not increase in patients with DVT (hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.43-2.75, = 0.855). On multivariate analysis, weight (adjusted HR 0.96, 95% CI 0.92-0.99, = 0.032), and metastasis (adjusted HR 10.26, 95% CI 2.35-44.9, = 0.002) were predictors of all-cause mortality. In conclusion, low weight and presence of metastases were associated with all-cause mortality, while presence of concomitant DVT was unrelated to poorer survival.
在有症状的急性肺栓塞（PE）中，深静脉血栓形成（DVT）的存在是30天和90天死亡率的一个危险因素。在患有癌症和偶发性PE的患者中，伴发的偶发性DVT的预后影响尚不清楚。在这项回顾性研究中，我们研究了偶发性DVT对此类患者全因死亡率的影响。对相关协变量采用校正后的Cox多变量回归分析。从2010年1月至2018年3月，我们纳入了200例患者（平均年龄65.3±12.4岁），随访时间为12.5个月（四分位间距7.4 - 19.4个月）。在这些患者中，62%有转移，31%伴发偶发性DVT，40.1%（n = 81）在随访期间死亡。DVT患者的全因死亡率没有增加（风险比[HR] 1.01，95%置信区间[CI] 0.43 - 2.75，P = 0.855）。多变量分析显示，体重（校正后HR 0.96，95% CI 0.92 - 0.99，P = 0.032）和转移（校正后HR 10.26，95% CI 2.35 - 44.9，P = 0.002）是全因死亡率的预测因素。总之，低体重和转移的存在与全因死亡率相关，而伴发DVT的存在与较差的生存率无关。
