Department of Radiology, Region Halland, Sweden.
Department of Radiology and Functional Imaging, Karolinska University Hospital, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Sweden.
Thromb Res. 2023 Apr;224:65-72. doi: 10.1016/j.thromres.2023.02.010. Epub 2023 Feb 21.
To assess the risk of recurrent venous thromboembolism (VTE) and death in patients with unreported cancer-associated incidental pulmonary embolism (iPE).
Matched cohort study on cancer patients with a CT study including the chest between 2014-01-01 and 2019-06-30. Studies were reviewed for unreported iPE, and cases were matched with controls without iPE. Cases and controls were followed for one year, with recurrent VTE and death as outcome events.
Of the included 2960 patients, 171 patients had unreported and untreated iPE. While controls had a one-year VTE risk of 8.2 events per 100 person-years, cases with a single subsegmental iPE had a recurrent VTE risk of 20.9 events, and between 52.0 and 72.0 events per 100 person-years for multiple subsegmental iPE and more proximal iPE. In multivariable analysis, multiple subsegmental and more proximal iPE were significantly associated with the risk of recurrent VTE, while single subsegmental iPE was not associated with the risk of recurrent VTE (p = 0.13). In the subgroup of patients (n = 47) with cancer not in the highest Khorana VTE risk category, no metastases and up to three involved vessels, recurrent VTE occurred in two patients (4.7 cases per 100 person-years). There were no significant associations between iPE burden and risk of death.
In cancer patients with unreported iPE, iPE burden was associated with the risk of recurrent VTE. However, having a single subsegmental iPE was not associated with the risk of recurrent VTE. There were no significant associations between iPE burden and risk of death.
评估未报告的癌症相关偶发性肺栓塞（iPE）患者发生复发性静脉血栓栓塞（VTE）和死亡的风险。
对 2014 年 1 月 1 日至 2019 年 6 月 30 日期间进行 CT 胸部检查的癌症患者进行了匹配队列研究。对未报告的 iPE 进行了研究回顾，并对病例进行了无 iPE 的对照匹配。对病例和对照进行了为期一年的随访，以复发性 VTE 和死亡为结局事件。
在纳入的 2960 例患者中，有 171 例患者存在未经报告和未经治疗的 iPE。在对照组中，1 年内 VTE 的风险为每 100 人年 8.2 例，而仅有单个亚段 iPE 的病例复发 VTE 的风险为 20.9 例，多个亚段 iPE 和更靠近近端的 iPE 的风险为每 100 人年 52.0 至 72.0 例。多变量分析显示，多个亚段和更靠近近端的 iPE 与复发性 VTE 的风险显著相关，而单个亚段 iPE 与复发性 VTE 的风险无关（p=0.13）。在癌症不属于 Khorana 最高 VTE 风险类别的患者（n=47）亚组中，没有转移且受累血管不超过 3 支，有 2 例患者（每 100 人年 4.7 例）发生复发性 VTE。iPE 负担与死亡风险之间没有显著关联。
在未报告的 iPE 的癌症患者中，iPE 负担与复发性 VTE 的风险相关。然而，单个亚段 iPE 与复发性 VTE 的风险无关。iPE 负担与死亡风险之间没有显著关联。
