Analysis of Clinical and Radiological Findings in Oncology Patients Undergoing Thoracic Tomography for Suspected Pulmonary Embolism

İyikesici, Fulya; Babuş, Seyran Bozkurt; Köse, Ataman; Erdoğan, Semra; Balcı, Yüksel

doi:10.1007/s12012-021-09684-9

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…Firstly, the higher frequency of pulmonary imaging, archetypical of patients treated for active malignancy, creates an inherent propensity towards asymptomatic PE selection bias in this population. [ 11 , 13 ] Secondly, previous investigators have suggested alternation in the physiologic response to pulmonary VTE in patients with malignancy. These include the lowering of hypoxic drive and the perception of dyspnea as well as alterations in pain perception.…”

Section: Discussionmentioning

confidence: 99%

“…Namely, some investigators have reported provoked PEs to be significantly smaller. [ 8 , 11 , 12 ] While undoubtedly attributable at least in part to detection bias, a higher activation of counter regulatory pathways in the presence of chronic VTE could explain the lower burden of VTE in this population. This in turn would explain the lack of compensatory physiology and ensuing “typical” symptoms of chest pain and dyspnea.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 ] Whereas the incidence and prevalence of PE is well described in patients with malignancy as well as other types of provocation, paucity of evidence exists as to the clinical presentation attributes in these special populations. [ 8 , 9 , 11 ] In particular, the rare and unusual clinical presentations in patients with malignancy or other predisposing factors for PE have not been systematically studied or reported.…”

Section: Introductionmentioning

confidence: 99%

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Clinical presentations of acute pulmonary embolism: A retrospective cohort study

Khasin,

Gur,

Evgrafov

et al. 2023

Medicine

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We aimed to investigate whether the unusual clinical presentation of pulmonary embolism (PE) varies by the type of provocation. In this retrospective cohort study, we examined the electronic health records (EHR) records of all patients diagnosed with PE (upon presentation or during hospitalization) presented to our tertiary hospital during 2014 to 2019. Inclusion criteria were the diagnosis of acute PE and age above 18 years. Excluded were all patients to whom complete EHR were not available. The primary outcome was the main presenting symptom, categorized by a multidisciplinary consensus expert committee as either typical or atypical of PE. Comorbidities, vital signs, medications and laboratory results on presentations were recorded. 591 patients were included in the final analysis. Dyspnea was significantly less common and hemoptysis and chest pain more common in the unprovoked PE group (35%, 5%, and 25%, respectively) compared with nonmalignant (42.6%, 0%, and 16.3%) and malignancy-associated (47.7%, 0.9%, and 8.2%) PE (Pv = 0.02, 0.002 and 0.001, respectively). No recorded symptoms were the third most common presentation overall, accounting for a significantly (Pv < 0.001) higher proportion of PE patients with malignancy (19%) whereas atypical presentation was the hallmark of patients with nonmalignant provokation (19.7%) (Pv = 0.005). Accounting for multiple potential confounders, the risk of atypical or asymptomatic presentation was higher with lower heart rates (RR = 0.974 95%C.I. [0.957–0.990]) and higher pulse oximetry saturation (RR = 1.114 95%CI [1.034–1.201]). The clinical presentation of PE varies with different types of provoking factors, with atypical presentation most common in nonmalignant provocation and asymptomatic presentation most prevalent in patients with underlying malignancy. Further studies are needed to determine the effect of said variance on long term clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical presentations of acute pulmonary embolism: A retrospective cohort study

Khasin,

Gur,

Evgrafov

et al. 2023

Medicine

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“…The repartition of the cancer site in cancer-associated PE from different studies is represented in Figure 2 . İyikesici et al investigated the clinical characteristics and CT scan findings of patients who underwent CT scans for suspected PE [ 16 ]. The EPIPHANY registry used by Weeda et al, Font, and Jiménez-Fonseca et al was designed to assess the clinical characteristics and outcomes of patients with cancer-associated (unsuspected) PE [ 10 ].…”

Section: Epidemiologymentioning

confidence: 99%

Pulmonary Embolism in the Cancer Associated Thrombosis Landscape

Poénou

Dumitru

Lafaie

et al. 2022

JCM

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In cancer patients, pulmonary embolism (PE) is the second leading cause of death after the cancer itself, most likely because of difficulties in diagnosing the disease due to its nonclassical presentation. The risk of PE recurrence and possibly the case-fatality rate depends on whether the patient presents a symptomatic PE, an unsuspected PE, a subsegmental PE, or a catheter-related PE. Choosing the best therapeutic option is challenging and should consider the risk of both the recurrence of thrombosis and the occurrence of bleeding. The purpose of this review is to provide an overview of the clinical characteristics and the treatment of cancer-associated PE, which could benefit clinicians to better manage the deadliest form of thrombosis associated with cancer. After a brief presentation of the epidemiological data, we will present the current attitude towards the diagnosis and the management of cancer patients with PE. Finally, we will discuss the perspectives of how the medical community can improve the management of this severe medical condition.

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Analysis of Clinical and Radiological Findings in Oncology Patients Undergoing Thoracic Tomography for Suspected Pulmonary Embolism

Cited by 2 publications

References 20 publications

Clinical presentations of acute pulmonary embolism: A retrospective cohort study

Clinical presentations of acute pulmonary embolism: A retrospective cohort study

Pulmonary Embolism in the Cancer Associated Thrombosis Landscape

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