engleski

Pulmonary embolism and malignant diseases

Introduction: Pulmonary embolism (PE) is a result of a sudden clot blockage in a lung artery. Active malignant disease promotes hypercoagulable state. Therefore it is an important risk factor in developing thromboembolic incident. Purpose: To evaluate clinical features and outcome among the oncologic and non-oncologic group of patients primarily hospitalized for pulmonary thromboembolism at the Department of Cardiovascular diseases during one year (2018). Methods: A retrospective study was performed on 124 patients with PE, during one year period. There were 33 oncological and 91 non-oncological patients. The difference according the hospital stay, demographic factors, underlying comorbidities, clinical presentation and diagnostic test results were analyzed between two subsets. Diagnostic approach included laboratory findings, ECG and imaging tests, i.e. chest X-ray, CTPA, Echocardiography and Doppler ultrasonography of lower limb peripheral veins .Therapeutic options and intrahospital survival rates were analyzed. Data was collected through the hospital information system. The principles of the Declaration of Helsinki of the World Medical Association were applied during the research. Numerical variables were given as the median and interquartile range. Categorical variables were expressed in percentages. Mann Whitney test was used in evaluating statistical significance for numerical data, and chi-squared test for analyzing categorical data. An alpha value of 0.05 was considered significant. Statistical analysis was conducted through program MedCalc@ v18.11.6. (MedCalc Software, Mariakerke, Belgium). Results: Presented tumors were intestinal (39%), lung (12%), breast (6%) and stomach cancer (6%), brain tumor (6%), pancreatic cancer (3%) and lymphoma (3%). The most common symptoms in both groups were dyspnoea (80.6%) and chest pain (33.9%), but oncologic patients were also in more cases presented as asymptomatic compared non-oncologic patients. Platelet count was 289 (196.25-316) x109/L in oncologic group and 214 (164-265) x109/L in non-oncologic group (p = .023). Haemoglobin was 123 (109.75-139) g/L in oncologic group and 136 (129-146) g/L in non-oncologic group (p = .004). Red distribution width (RDW) was 29.8% (29.8-29.8) in oncologic group and 13.7% (13.1-16) in non-oncologic group (p < .001). Oral anticoagulation was therapeutic option for non-oncologic patients, while low molecular weight heparin (LMWH) was more often administred in patients with malignant disease. Conclusion: PE is common diagnosis in oncologic population. In our study PE was most frequently related to intestinal cancer. It is often presented without symptoms and incidentally diagnosed by imaging tests. Anemia, thrombocytosis and elevated RDW are more often presented in oncologic patients with PE, likewise oncologic patients are treated with LMWH more often than with oral anticoagulants.

pulmonary embolism ; malignant diseases

nije evidentirano