Clinical Characteristics, Risk Factors, and Outcomes of Cancer and Noncancer Patients with Hospital-Acquired Pulmonary Embolism: A Retrospective Cohort Study

OBJECTIVE This study compared clinical features, risk factors, and outcomes between cancer and non-cancer patients with hospital-acquired pulmonary embolism (HA-PE). METHODS A retrospective analysis of 287 HA-PE patients (186 non-cancer and 101 cancer) was conducted using R for statistical analysis and outcome comparison. RESULTS Cancer was found to be the most significant risk factor for all-cause mortality in HA-PE patients (hazard ratios [HR] 4.36, 95% confidence intervals [CI] 2.78-6.86, p < 0.001). During follow-up, patients with cancer demonstrated significantly higher all-cause mortality (55.45% vs. 33.33%, p < 0.001) and shorter median survival time (12.6 vs. 28.5 months, p < 0.001) compared with non-cancer patients. Distant metastasis (HR 2.54, 95% CI 1.12-5.77, p = 0.026) was identified as an independent risk factor for death in cancer patients with HA-PE. In contrast, anticoagulation therapy alone (HR 0.30, 95% CI 0.10-0.88, p = 0.028), and pulmonary artery thrombectomy (HR 0.06, 95% CI 0.01-0.34, p = 0.001) initiated after HA-PE onset were associated with a significant reduction in mortality risk. CONCLUSION HA-PE patients with concomitant cancer, especially those with distant metastases, have an extremely poor prognosis with a markedly increased risk of mortality. Clinically, greater emphasis should be placed on thromboprophylaxis and early intervention in this population, with proactive use of anticoagulation and, when indicated, adjunctive interventions such as pulmonary artery thrombectomy to substantially improve survival outcomes.