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偶然发现和有症状的肺栓塞的肿瘤内科患者的特征和 6 个月死亡率:一项单机构回顾性纵向分析。

Characteristics and 6-Month Mortality of Medical Oncology Patients With Incidental and Symptomatic Pulmonary Embolism: A Single-Institutional Retrospective Longitudinal Analysis.

机构信息

Department of Respiratory Disease, Ningbo Hospital, Zhejiang University School of Medicine, Zhejiang University, Ningbo, Zhejiang, China.

Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231155177. doi: 10.1177/10760296231155177.

Abstract

This study aimed to identify clinical characteristics of cancer patients with incidental pulmonary embolism (IPE) and assess the variables associated with 30-day mortality in cancer patients with PE including symptomatic pulmonary embolism (SPE) and IPE. 6-Month mortality rate in cancer patients with SPE and IPE were also compared. We retrospectively analyzed electronic medical records of cancer patients with newly diagnosed PE between January 2016 and June 2021. We compared clinical and radiological characteristics in cancer patients with IPE and SPE and identified variables associated with the overall 30-day mortality on multivariate analysis. All patients were followed up for 6 months and survival analysis was performed by use of Kaplan-Meier. Five hundred and nine eligible cancer patients with pulmonary embolism were identified during the study period. IPE is associated with lower BMI, colorectal and pancreas cancers, stage III/IV of cancer, recent antiangiogenic therapy, central venous catheter (CVC) and chronic cardiac or respiratory disease compared to SPE. The factors associated with 30-day mortality included poor performance status, lung/pleura or upper gastrointestinal cancers, stage III/IV of cancer, previous VTE, oxygen saturation < 95%, lactic acid > 2 mmol/l and bilateral PE. The overall survival in patients with IPE at 6-month follow-up was similar to those diagnosed with SPE. The present study has allowed the identification of factors associated with 30-day mortality in cancer patients with IPE and SPE. We also found similar mortality rate in cancer patients with IPE compared with patients with SPE at 6-month follow-up.

摘要

本研究旨在确定偶然发现的肺栓塞(IPE)癌症患者的临床特征,并评估与包括有症状肺栓塞(SPE)和 IPE 在内的癌症患者的 30 天死亡率相关的变量。还比较了 SPE 和 IPE 癌症患者的 6 个月死亡率。我们回顾性分析了 2016 年 1 月至 2021 年 6 月期间新诊断为 PE 的癌症患者的电子病历。我们比较了 IPE 和 SPE 癌症患者的临床和影像学特征,并在多变量分析中确定了与总 30 天死亡率相关的变量。所有患者均随访 6 个月,并通过 Kaplan-Meier 进行生存分析。在研究期间,共确定了 509 例符合条件的肺栓塞癌症患者。与 SPE 相比,IPE 与 BMI 较低、结直肠癌和胰腺癌、癌症 III/IV 期、近期抗血管生成治疗、中心静脉导管(CVC)和慢性心脏或呼吸系统疾病有关。与 30 天死亡率相关的因素包括较差的表现状态、肺/胸膜或上胃肠道癌症、癌症 III/IV 期、以前的 VTE、氧饱和度<95%、乳酸>2mmol/L 和双侧 PE。在 6 个月随访时,IPE 患者的总体生存率与诊断为 SPE 的患者相似。本研究能够确定与 IPE 和 SPE 癌症患者 30 天死亡率相关的因素。我们还发现,在 6 个月随访时,IPE 癌症患者的死亡率与 SPE 患者相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e65/9909045/4895d25f72c1/10.1177_10760296231155177-fig1.jpg

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