Department of Medicine, John H. Stroger Jr Hospital of Cook County, 1969 West Ogden Avenue, Chicago, IL, 60612, USA.
Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.
J Thromb Thrombolysis. 2022 Nov;54(4):630-638. doi: 10.1007/s11239-022-02684-8. Epub 2022 Jul 25.
A substantial proportion of patients with malignancy develop pulmonary embolism (PE), which significantly worsens the prognosis and ranks as one of the leading causes of mortality in these patients. This retrospective study aimed to examine prognosis of PE in 17 different types of malignancies. All hospitalizations for a primary diagnosis of PE, were identified from the National Inpatient Sample from 2016 to 2018 and divided into those with and without malignancies. Propensity score matching was performed with malignancy as the dependent variable and 23 clinically relevant covariates. Malignancy was stratified into 17 different types of cancer, for which the odds of in-hospital mortality were calculated. After propensity score matching, 82,970 hospitalizations for PE each were allocated into those with and without malignancy groups. PE in all types of malignancies had significantly higher odds of in-hospital mortality compared to PE without malignancy (OR 2.27, 95% CI 2.03-2.54). When stratified to types, esophageal cancer (OR 4.05, 95% CI 2.77-5.92) was associated with the highest odds of in-hospital mortality, followed by gastric (OR 3.41, 95% CI 2.25-5.16) and ovarian cancer (OR 2.95, 95% CI 2.12-4.13). On sensitivity analysis, only PE in esophageal and lung cancer was associated with higher odds of in-hospital mortality compared to PE in all other malignancies combined. Hospitalizations for PE in patients with malignancy were associated with higher odds of in-hospital mortality than those without malignancy. Esophageal cancer had the highest odds of in-hospital mortality, followed by gastric, ovarian, and lung cancer.
相当比例的恶性肿瘤患者会发生肺栓塞（PE），这显著恶化了患者的预后，并成为此类患者死亡的主要原因之一。本回顾性研究旨在探讨 17 种不同类型恶性肿瘤的 PE 预后。从 2016 年至 2018 年，国家住院患者样本中确定了所有因首次诊断为 PE 的住院患者，并将其分为合并恶性肿瘤和未合并恶性肿瘤的患者。以恶性肿瘤为因变量，采用倾向评分匹配法进行 23 项临床相关协变量分析。将恶性肿瘤分为 17 种不同类型的癌症，并计算这些癌症患者住院期间的死亡率。经倾向评分匹配后，将 82970 例 PE 住院患者分别分配至合并恶性肿瘤和未合并恶性肿瘤组。与无恶性肿瘤的 PE 相比，所有类型恶性肿瘤的 PE 患者住院期间的死亡率均显著升高（OR 2.27，95%CI 2.03-2.54）。分层至各类型后，食管癌（OR 4.05，95%CI 2.77-5.92）的死亡率最高，其次为胃癌（OR 3.41，95%CI 2.25-5.16）和卵巢癌（OR 2.95，95%CI 2.12-4.13）。敏感性分析显示，仅食管和肺癌的 PE 患者与其他所有恶性肿瘤合并的 PE 患者相比，其住院期间的死亡率更高。与无恶性肿瘤的患者相比，合并恶性肿瘤的 PE 患者的住院期间死亡率更高。食管癌的死亡率最高，其次为胃癌、卵巢癌和肺癌。
