The course of the pulmonary embolism in patients with oncological diseases

Abstract

The aim – to identify factors associated with in-hospital mortality among patients with acute pulmonary embolism (PE) and oncological diseases. Materials and methods. A retrospective analysis of 647 medical records of patients with acute PE treated at one center from January 1, 2018, to January 1, 2020, was conducted. Among them, 115 patients had verified oncological diseases. PE diagnosis in all patients was confirmed by computed tomography and/or autopsy results. Alongside laboratory studies, patients underwent ultrasound examination. Results and discussion. A comparative assessment of clinical and anamnestic parameters in patients with PE, depending on the presence of oncological diseases, was conducted. The analysis revealed that patients with PE associated with oncological process were on average 5 years older, with higher proportion of elderly patients, and less frequently had anamnestic episodes of venous thrombosis (13.9 % vs. 24.6 %), but predictably more often had additional risk factors, such as blood transfusions, central venous catheters, and laparoscopic interventions. According to the results of the multifactorial regression analysis, factors independently influencing the risk of in-hospital death in patients with acute PE and oncological diseases included decrease of blood pressure, saturation, an increase of the pulmonary artery pressure, leukocytosis and presence of atrial fibrillation. The ROC analysis results allowed determining threshold values of parametric indicators associated with the risk of death during the hospital period in a patient with PE and oncological diseases, i.e. blood pressure ≤ 105 mm Hg, SpO2 ≤ 87 %, pulmonary artery pressure > 48 mm Hg, and leukocyte count > 9.8  109/l. Conclusion. The risk factors of in-hospital death in patients with PE associated with oncological disease are atrial fibrillation, increased pulmonary artery pressure, leukocyte count, low blood pressure and saturation.