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Published in: International Journal of Clinical Oncology 6/2019

01-06-2019 | Venous Thrombosis | Original Article

Saddle pulmonary embolism and in-hospital mortality in patients with cancer

Authors: Ashley Prentice, Irene Ruiz, Erin R. Weeda

Published in: International Journal of Clinical Oncology | Issue 6/2019

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Abstract

Purpose

Saddle pulmonary embolism (PE) has been associated with an increased risk of 1 year mortality when compared to non-saddle PE among patients with cancer. We sought to evaluate the association between saddle PE and in-hospital outcomes among patients with comorbid cancer.

Methods

The 2013 and 2014 United States National Inpatient Sample was used to identify adult patients hospitalized for acute PE. Only patients with an International Classification Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code indicating comorbid cancer were included. Identified admissions were stratified into the following 2 cohorts: saddle (defined as ICD-9-CM code = 415.13) and non-saddle PE. Multivariable logistic regression was performed to determine the association between saddle PE and the odds of in-hospital mortality after adjustment for age ≥ 80 years and sex.

Results

A total of 10,660 admissions for acute PE in patients with comorbid cancer were identified. Of which, 4.5% (n = 475) had a saddle PE. Median age was 67 years (interquartile range = 58–76) and 48.9% were male. In-hospital mortality occurred in 6.1% of patients. Upon multivariable adjustment, the odds of in-hospital mortality were higher in saddle versus non-saddle PE (odds ratio = 1.51; 95% confidence interval 1.08–2.10).

Conclusion

In this retrospective study of admissions for acute PE in patients with comorbid cancer, saddle PE was associated with a higher odds of in-hospital mortality.
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Literature
1.
go back to reference Heit JA, Silverstein MD, Mohr DN et al (2000) Risk factors for deep vein thrombosis and pulmonary embolism. Arch Intern Med 160:809–815CrossRefPubMed Heit JA, Silverstein MD, Mohr DN et al (2000) Risk factors for deep vein thrombosis and pulmonary embolism. Arch Intern Med 160:809–815CrossRefPubMed
2.
go back to reference Winter PC (2006) The pathogenesis of venous thromboembolism in cancer: emerging links with tumour biology. Hematol Oncol 24:126–133CrossRefPubMed Winter PC (2006) The pathogenesis of venous thromboembolism in cancer: emerging links with tumour biology. Hematol Oncol 24:126–133CrossRefPubMed
3.
go back to reference Prandoni P, Lensing AW, Piccioli A et al (2002) Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 100:3484–3488CrossRef Prandoni P, Lensing AW, Piccioli A et al (2002) Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 100:3484–3488CrossRef
4.
go back to reference Pathak R, Giri S, Karmacharya et al (2015) Comparison between saddle versus non-saddle pulmonary embolism: insights from nationwide inpatient sample. Int J Cardiol 180:58–59CrossRefPubMed Pathak R, Giri S, Karmacharya et al (2015) Comparison between saddle versus non-saddle pulmonary embolism: insights from nationwide inpatient sample. Int J Cardiol 180:58–59CrossRefPubMed
5.
go back to reference Yusuf SW, Gladish G, Lenihan DJ et al (2010) Computerized tomographic finding of saddle pulmonary embolism is associated with high mortality in cancer patients. Intern Med J 40:293–299CrossRefPubMed Yusuf SW, Gladish G, Lenihan DJ et al (2010) Computerized tomographic finding of saddle pulmonary embolism is associated with high mortality in cancer patients. Intern Med J 40:293–299CrossRefPubMed
8.
go back to reference Ryu JH, Pellikka PA, Froehling DA et al (2007) Saddle pulmonary embolism diagnosed by CT angiography: frequency, clinical features and outcome. Respir Med 101:1537–1542CrossRefPubMed Ryu JH, Pellikka PA, Froehling DA et al (2007) Saddle pulmonary embolism diagnosed by CT angiography: frequency, clinical features and outcome. Respir Med 101:1537–1542CrossRefPubMed
10.
go back to reference Casazza F, Becattini C, Rulli E et al (2016) Clinical presentation and in-hospital death in acute pulmonary embolism: does cancer matter? Intern Emerg Med 11:817–824CrossRefPubMed Casazza F, Becattini C, Rulli E et al (2016) Clinical presentation and in-hospital death in acute pulmonary embolism: does cancer matter? Intern Emerg Med 11:817–824CrossRefPubMed
11.
go back to reference Lau JK, Chow V, Brown A et al (2017) Predicting in-hospital death during acute presentation with pulmonary embolism to facilitate early discharge and outpatient management. PLoS One 12:e0179755CrossRefPubMedPubMedCentral Lau JK, Chow V, Brown A et al (2017) Predicting in-hospital death during acute presentation with pulmonary embolism to facilitate early discharge and outpatient management. PLoS One 12:e0179755CrossRefPubMedPubMedCentral
12.
go back to reference Banala SR, Yeung SJ, Rice TW et al (2017) Discharge or admit? Emergency department management of incidental pulmonary embolism in patients with cancer: a retrospective study. Int J Emerg Med 10:19CrossRefPubMedPubMedCentral Banala SR, Yeung SJ, Rice TW et al (2017) Discharge or admit? Emergency department management of incidental pulmonary embolism in patients with cancer: a retrospective study. Int J Emerg Med 10:19CrossRefPubMedPubMedCentral
13.
go back to reference Dudzinski DM, Piazza G (2016) Multidisciplinary pulmonary embolism response teams. Circulation 133:98–103CrossRefPubMed Dudzinski DM, Piazza G (2016) Multidisciplinary pulmonary embolism response teams. Circulation 133:98–103CrossRefPubMed
14.
go back to reference Nguyen E, Caranfa J, Lyman GH et al (2018) Clinical prediction rules for mortality in patients with pulmonary embolism and cancer to guide outpatient management: a meta-analysis. J Thromb Haemost 16:279–292CrossRefPubMed Nguyen E, Caranfa J, Lyman GH et al (2018) Clinical prediction rules for mortality in patients with pulmonary embolism and cancer to guide outpatient management: a meta-analysis. J Thromb Haemost 16:279–292CrossRefPubMed
15.
go back to reference Weeda ER, Caranfa JT, Zeichner SB et al (2017) External validation of generic and cancer-specific risk stratification tools in patients with pulmonary embolism and active cancer. J Natl Compr Cancer Netw 15:1476–1482CrossRef Weeda ER, Caranfa JT, Zeichner SB et al (2017) External validation of generic and cancer-specific risk stratification tools in patients with pulmonary embolism and active cancer. J Natl Compr Cancer Netw 15:1476–1482CrossRef
16.
go back to reference Chan L, McGarey P, Sclafani JA (2018) Using large data sets for population-based health research. In: Gallin JI, Ognibene FP, Johnson LL (eds) Principles and practice of clinical research. Elsevier, London Chan L, McGarey P, Sclafani JA (2018) Using large data sets for population-based health research. In: Gallin JI, Ognibene FP, Johnson LL (eds) Principles and practice of clinical research. Elsevier, London
17.
go back to reference Tamariz L, Harkins T, Nair V (2012) A systematic review of validated methods for identifying venous thromboembolism using administrative and claims data. Pharmacoepidemiol Drug Saf 21(Suppl 1):154–162CrossRefPubMed Tamariz L, Harkins T, Nair V (2012) A systematic review of validated methods for identifying venous thromboembolism using administrative and claims data. Pharmacoepidemiol Drug Saf 21(Suppl 1):154–162CrossRefPubMed
Metadata
Title
Saddle pulmonary embolism and in-hospital mortality in patients with cancer
Authors
Ashley Prentice
Irene Ruiz
Erin R. Weeda
Publication date
01-06-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 6/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01406-0

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