1. Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study
- Author
-
Font, Carme, Carmona-Bayonas, Alberto, Beato, Carmen, Reig, Oscar, Saez, Antonia, Jimenez-Fonseca, Paula, Plasencia, Juana M., Calvo-Temprano, David, Sanchez, Marcelo, Benegas, Mariana, Biosca, Mercedes, Varona, Diego, Angeles Vicente, Maria, Faez, Laura, del Pilar Solis, Maria, de la Haba, Irma, Antonio, Maite, Madridano, Olga, Castanon, Eduardo, Jose Martinez, Maria, Marchena, Pablo, Ramchandani, Avinash, Dominguez, Angel, Puerta, Alejandro, Martinez de la Haza, David, Pueyo, Jesus, Hernandez, Susana, Fernandez-Plaza, Angela, Martinez-Encarnacion, Lourdes, Martin, Mar, Marin, Gema, Ayala, Francisco, Vicente, Vicente, Otero, Remedios, Asociacion Invest Enfermedad Tromo, [Font, Carme] Hosp Clin Barcelona, Dept Med Oncol, IDIBAPS Translat Genom & Targeted Therapeut Solid, Villarroel 170, E-08036 Barcelona, Spain, [Reig, Oscar] Hosp Clin Barcelona, Dept Med Oncol, IDIBAPS Translat Genom & Targeted Therapeut Solid, Villarroel 170, E-08036 Barcelona, Spain, [Carmona-Bayonas, Alberto] Hosp Univ Morales Meseguer, Med Oncol & Hematol Dept, Murcia, Spain, [Angeles Vicente, Maria] Hosp Univ Morales Meseguer, Med Oncol & Hematol Dept, Murcia, Spain, [Ayala, Francisco] Hosp Univ Morales Meseguer, Med Oncol & Hematol Dept, Murcia, Spain, [Vicente, Vicente] Hosp Univ Morales Meseguer, Med Oncol & Hematol Dept, Murcia, Spain, [Beato, Carmen] Hosp Nisa Aljarafe, Dept Med Oncol, Seville, Spain, [Saez, Antonia] Axioma Comunicac, Dept Stat, Seville, Spain, [Jimenez-Fonseca, Paula] Hosp Univ Cent Asturias, Dept Med Oncol, Oviedo, Spain, [Faez, Laura] Hosp Univ Cent Asturias, Dept Med Oncol, Oviedo, Spain, [del Pilar Solis, Maria] Hosp Univ Cent Asturias, Dept Med Oncol, Oviedo, Spain, [Plasencia, Juana M.] Hosp Univ Morales Meseguer, Dept Radiol, Murcia, Spain, [Calvo-Temprano, David] Hosp Univ Cent Asturias, Dept Radiol, Oviedo, Spain, [Sanchez, Marcelo] Hosp Clin Barcelona, Radiodiagnost Dept, Barcelona, Spain, [Benegas, Mariana] Hosp Clin Barcelona, Radiodiagnost Dept, Barcelona, Spain, [Biosca, Mercedes] Hosp Univ Vall Hebron, Dept Med Oncol, Barcelona, Spain, [Varona, Diego] Hosp Univ Vall Hebron, Dept Radiol, Barcelona, Spain, [de la Haba, Irma] Hosp Llobregat, Hosp Duran & Reynals, Inst Catalad Oncol, Dept Med Oncol, Barcelona, Spain, [Antonio, Maite] Hosp Llobregat, Hosp Duran & Reynals, Inst Catalad Oncol, Dept Med Oncol, Barcelona, Spain, [Madridano, Olga] Hosp Infanta Sof San Sebastian Ios Reves, Dept Internal Med, Madrid, Spain, [Martin, Mar] Hosp Infanta Sof San Sebastian Ios Reves, Dept Internal Med, Madrid, Spain, [Castanon, Eduardo] Univ Navarra Clin, Dept Med Oncol, Pamplona, Spain, [Jose Martinez, Maria] Hosp Santa Lucia, Dept Med Oncol, Murcia, Spain, [Marchena, Pablo] Hosp San Juan Dios, Dept Internal Med, Esplugues Llobregat, Barcelona, Spain, [Ramchandani, Avinash] Hosp Insular Gran Canaria, Dept Med Oncol, Las Palmas Gran Canaria, Spain, [Dominguez, Angel] Hosp Nisa Aljarafe, Dept Radiol, Seville, Spain, [Puerta, Alejandro] Hosp Reina Sofia, Dept Radiol, Murcia, Spain, [Martinez de la Haza, David] Hosp Llobregat, Hosp Duran & Reynals, Inst Catalad Oncol, Dept Radiol, Barcelona, Spain, [Pueyo, Jesus] Univ Navarra Clin, Dept Radiol, Pamplona, Spain, [Hernandez, Susana] Hosp Infanta Sofia San Sebastian los Reves, Dept Radiol, Madrid, Spain, [Fernandez-Plaza, Angela] Hosp Santa Lucia, Dept Radiol, Murcia, Spain, [Martinez-Encarnacion, Lourdes] Hosp Santa Lucia, Dept Radiol, Murcia, Spain, [Marin, Gema] Hosp Clin Univ Virgen la Arrixaca, Dept Med Oncol, Murcia, Spain, [Otero, Remedios] HUVR IBiS, CIBERES, Dept Pneumol, Seville, Spain, and LEO Pharma Spain
- Subjects
Male ,Time Factors ,030204 cardiovascular system & hematology ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,Neoplasms ,Diagnosis ,Young adult ,Aged, 80 and over ,Adversely impact survival ,Mortality rate ,Venous Thromboembolism ,Middle Aged ,Pulmonary embolism ,030220 oncology & carcinogenesis ,Cohort ,Female ,medicine.symptom ,Cohort study ,Venous thromboembolism ,Pulmonary and Respiratory Medicine ,Adult ,Risk ,medicine.medical_specialty ,Adolescent ,Hemorrhage ,Guidelines ,Asymptomatic ,Risk Assessment ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,Aged ,Performance status ,business.industry ,Outpatient management ,Severity index ,Cancer ,medicine.disease ,Surgery ,Logistic Models ,Spain ,Multivariate Analysis ,business ,Pulmonary Embolism ,Tomography, X-Ray Computed ,Prognostic model - Abstract
The study aimed to identify predictors of overall 30-day mortality in cancer patients with pulmonary embolism including suspected pulmonary embolism (SPE) and unsuspected pulmonary embolism (UPE) events. Secondary outcomes included 30- and 90-day major bleeding and venous thromboembolism (VTE) recurrence.The study cohort included 1033 consecutive patients with pulmonary embolism from the multicentre observational ambispective EPIPHANY study (March 2006–October 2014). A subgroup of 497 patients prospectively assessed for the study were subclassified into three work-up scenarios (SPE, truly asymptomatic UPE and UPE with symptoms) to assess outcomes.The overall 30-day mortality rate was 14%. The following variables were associated with the overall 30-day mortality on multivariate analysis: VTE history, upper gastrointestinal cancers, metastatic disease, cancer progression, performance status, arterial hypotension 110 beats·min−1, basal oxygen saturation versus overall UPE).The overall 30-day mortality was significantly lower in patients with truly asymptomatic UPE events (3%) compared with those with UPE-S (20%) and SPE (21%) (pIn conclusion, variables associated with the severity of cancer and pulmonary embolism were associated with short-term mortality. Our findings may help to develop pulmonary embolism risk-assessment models in this setting.
- Published
- 2017