High D-dimer is a predictor for short-term mortality in patients with active cancer and acute pulmonary embolism

Abstract

Objectives: Acute pulmonary embolism (PE) is the main cause of death in cancer patients, but there are limited prognostic tools for the patients with active cancer and acute PE. We aimed to identify prognostic factors of 30-day mortality in patients with active cancer and acute PE. Methods: This retrospective observational study included all adult patients aged ≥18 years with active cancer and acute PE from February 2017 to February 2019 at the emergency department in tertiary care hospital, Seoul, Korea. The primary outcome is 30-day mortality. Results: A total of 178 patients were included with a mean age of 63.9 years (SD 10.4) and males of 52.8%. The overall 30-day mortality rate was 30.9%. In a multivariable logistic analysis, high D-dimer, defined as ≥median value of 14.7 µg/mL, with odds ratio (OR) 2.47 (95% confidence interval [CI], 1.15–5.33), high Pulmonary Embolism Severity Index (PESI) scores with OR 2.95 (95% CI, 1.21–7.75) for class IV and OR 2.90 (95% CI, 1.06–7.90) for class V, and Eastern Cooperative Oncology Group (ECOG) performance status 3/4 with OR 3.22 (95% CI, 1.18–8.76) were independent predictors of 30-day mortality. Conclusion: High D-dimer values, high PESI scores, and poor ECOG performance status may be reliable predictors of mortality in patients with active cancer and acute PE.