Abstract
In symptomatic acute pulmonary embolism (PE), the presence of deep vein thrombosis (DVT) is a risk factor for 30- and 90-day mortality. In patients with cancer and incidental PE, the prognostic effect of concomitant incidental DVT is unknown. In this retrospective study, we examined the effect of incidental DVT on all-cause mortality in such patients. Adjusted Cox multivariate regression analysis was used for relevant covariates. From January 2010 to March 2018, we included 200 patients (mean age, 65.3 ± 12.4 years) who were followed up for 12.5 months (interquartile range 7.4–19.4 months). Of these patients, 62% had metastases, 31% had concomitant incidental DVT, and 40.1% (n = 81) died during follow-up. All-cause mortality did not increase in patients with DVT (hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.43–2.75, p = 0.855). On multivariate analysis, weight (adjusted HR 0.96, 95% CI 0.92–0.99, p = 0.032), and metastasis (adjusted HR 10.26, 95% CI 2.35–44.9, p = 0.002) were predictors of all-cause mortality. In conclusion, low weight and presence of metastases were associated with all-cause mortality, while presence of concomitant DVT was unrelated to poorer survival.
Highlights
Venous thromboembolic (VTE) disease includes pulmonary embolism (PE) and deep venous thrombosis (DVT); these manifestations of the same disease have different clinical courses and prognoses [1,2]
We evaluated 234 patients with incidental PE, 34 of whom were excluded because they did not have a diagnosis of cancer (Figure 1)
Our study is the first to analyze the effect of incidental deep vein thrombosis (DVT) in patients with incidental PE, and we proposed all-cause mortality at six months and at 30 and 90 days
Summary
Venous thromboembolic (VTE) disease includes pulmonary embolism (PE) and deep venous thrombosis (DVT); these manifestations of the same disease have different clinical courses and prognoses [1,2]. Estimates derived from epidemiological data show the rate of incidental PE in the course of symptomatic DVT to be between 35% and 66% [5,6]. Jiménez et al reported that patients with concomitant DVT had, compared with those without DVT, an increased risk of all-cause death, supporting the hypothesis that an increased thrombus burden can lead to a poor prognosis [8]. Several studies that have investigated the prognosis of concomitant DVT in patients with acute PE have reported conflicting data [3,8,9,10,11,12,13,14,15]. A meta-analysis showed that the presence of DVT was associated with a higher risk of death in the short-term for patients with symptomatic acute PE [16]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
