Malignant tumor is the greatest risk factor for pulmonary embolism in hospitalized patients: a single-center study

Abstract

Background This study aimed to investigate the background of patients who presented with pulmonary embolism (PE) on contrast-enhanced chest computed tomography (CT) and to explore the risk factors for PE. Methods This study included a review of the medical records of all 50,621 patients who were admitted to one community hospital between January 1, 2013 and December 31, 2017. Data on sex, age, risk factors related to blood flow stagnation (obesity, long-term bed rest, cardiopulmonary disease, cast fixation, long-term sitting), risk factors related to vascular endothelial disorder (surgery, trauma/fracture, central venous catheterization, catheter tests/treatments, vasculitis, antiphospholipid antibody syndrome, history of venous thromboembolism (VTE)), and risk factors related to hypercoagulability (malignant tumor, use of oral contraceptives/low-dose estrogen progestin/steroids, infection, inflammatory enteric disease, polycythemia, protein C or protein S deficiency, dehydration) were evaluated. Results Of all inpatients, 179(0.35%) out of 50,621 were diagnosed with PE after contrast-enhanced chest CT examination, in which 74 patients were symptomatic and 105 patients had no symptom. Among asymptomatic 105 patients, 71 patients got CT scans for other reasons including cancer screening and searching infection focus, and 34 patients got CT scans for searching PE due to either apparent or suspicious DVT. The rate of discovering PE was significantly greater in women (0.46%, 90/19,409) than men (0.29%, 89/31,212) (P = 0.008). Of the 179 patients with PE, 164 (92%) had some type of risk factor. For both men and women, the most frequent risk factor was a malignant tumor, followed by obesity, long-term bed rest and infection for men and long-term bed rest, obesity and infection for women. The most common malignant tumor was lung cancer. Although taking antipsychotic agent is not advocated as a risk factor, there is a possibility of involvement. Conclusions The risk factors for PE were identified in this single-center, retrospective study.

Risk factors and potential predictors of pulmonary embolism in cancer patients undergoing thoracic and abdominopelvic surgery: a case control study

“…Besides the well-established risk factors for PE including advanced age, obesity, long-time bed rest, prolonged operation times, malignant tumor is the greatest risk factor for PE in hospitalized patients according to the literature [9]. Furthermore, malignancy-related risk factors such as cancer type, cancer stage and primary site have been documented to be associated with VTE and PE in cancer patients [10,11].…”

Anatomic distribution of lower extremity deep venous thrombosis is associated with an increased risk of pulmonary embolism: A 10-year retrospective analysis

“…Moreover, obesity and hypertension were found to be independently associated with PE, while age (Model 2, P = 0.052) and sex (Model 2, P = 0.075) were close to achieving statistical significance. Indeed, age, sex and obesity have already clearly been identified as risk factors for PE ( 40 ). Interestingly, the adjusted ORs of hypertension were less than 1.0, implying that hypertension appeared to be a protective factor for PE, which seems controversial with clinical practice.…”

“…Cancer has long been recognized as an important risk factor for PE ( 28 , 40 ). In this study, patients with PE had a higher proportion of cancer than those without (20.54% vs. 14.42%), and univariate analysis showed that patients with cancer had a 1.535-fold increase in PE risk ( P = 0.026).…”

Risk factors for patients with acute hospital-acquired symptomatic pulmonary thromboembolism

“…Approximately 3.1 million new cases are diagnosed in China every year, and this number has been increasing each year 18 , 19 . Depending on the severity of the embolism, both symptomatic and asymptomatic embolism can occur 20 , 21 . Acute SPE is a condition we must be on high alert for because it may be life-threatening 9 .…”