Department of Cardiology, Herlev and Gentofte Hospital University of Copenhagen Hellerup Denmark.
Danish Heart Foundation Copenhagen Denmark.
J Am Heart Assoc. 2023 Dec 5;12(23):e030191. doi: 10.1161/JAHA.123.030191. Epub 2023 Nov 28.
New treatment regimens have been introduced in the past 20 years, which may influence the short- and long-term prognosis for patients with and without a cancer diagnosis following pulmonary embolism. However, newer studies investigating these trends are lacking. Therefore, we aimed to investigate the 30- and 31- to 365-day mortality following pulmonary embolism.
Using the Danish nationwide registries, patients with a diagnosis of pulmonary embolism between 2000 and 2020 were included. Age- and sex-standardized 30- and 31- to 365-day mortality was calculated and stratified by cancer status. In total, 60 614 patients (29.6% with recent cancer; mean age, 68.2 years) were included. The 30-day mortality for patients with no recent cancer decreased from 19.1% (95% CI, 17.9%-20.4%) in 2000 to 7.3% (95% CI, 6.7%-8.0%) in 2018 to 2020 (hazard ratio [HR], 0.36 [95% CI, 0.32-0.40]; <0.001). The 30-day mortality for patients with recent cancer decreased from 32.2% (95% CI, 28.8%-36.6%) to 14.1% (95% CI, 12.7%-15.5%) (HR, 0.38 [95% CI, 0.33-0.44]; <0.001). The 31- to 365-day mortality for patients with no recent cancer decreased from 12.5% (95% CI, 11.4%-13.6%) to 9.4% (95% CI, 8.6%-10.2%) (HR, 0.73 [95% CI, 0.64-0.83]; <0.001).The 31- to 365-day mortality for patients with recent cancer remained stable: 39.4% (95% CI, 35.1%-43.7%) to 38.3% (95% CI, 35.9%-40.6%) (HR, 0.97 [95% CI, 0.84-1.12]; =0.69).
From 2000 to 2020, improvements were observed in 30-day mortality following pulmonary embolism regardless of cancer status. For patients with recent cancer, 31- to 365-day mortality did not improve, whereas a minor improvement was observed for patients without recent cancer.
在过去的 20 年中,引入了新的治疗方案,这可能会影响患有和不患有癌症的肺栓塞患者的短期和长期预后。然而,缺乏研究这些趋势的较新研究。因此,我们旨在调查肺栓塞后 30 天和 31 至 365 天的死亡率。
使用丹麦全国登记处,纳入了 2000 年至 2020 年间诊断为肺栓塞的患者。计算了年龄和性别标准化的 30 天和 31 至 365 天死亡率,并按癌症状态进行分层。共纳入 60614 例患者(最近癌症患者占 29.6%;平均年龄 68.2 岁)。无近期癌症的患者的 30 天死亡率从 2000 年的 19.1%(95%CI,17.9%-20.4%)下降至 2018 年至 2020 年的 7.3%(95%CI,6.7%-8.0%)(危险比[HR],0.36[95%CI,0.32-0.40];<0.001)。最近患有癌症的患者的 30 天死亡率从 32.2%(95%CI,28.8%-36.6%)降至 14.1%(95%CI,12.7%-15.5%)(HR,0.38[95%CI,0.33-0.44];<0.001)。无近期癌症的患者的 31 至 365 天死亡率从 12.5%(95%CI,11.4%-13.6%)下降至 9.4%(95%CI,8.6%-10.2%)(HR,0.73[95%CI,0.64-0.83];<0.001)。最近患有癌症的患者的 31 至 365 天死亡率保持稳定:39.4%(95%CI,35.1%-43.7%)至 38.3%(95%CI,35.9%-40.6%)(HR,0.97[95%CI,0.84-1.12];=0.69)。
从 2000 年到 2020 年,无论癌症状态如何,肺栓塞后 30 天死亡率均有所改善。对于最近患有癌症的患者,31 至 365 天的死亡率没有改善,而无近期癌症的患者的死亡率略有改善。