Association of Serum Oncostatin M with In-Hospital Mortality in Acute Pulmonary Embolism: A Prospective Cohort Study

Early risk stratification in acute pulmonary embolism (PE) guides emergency management. Oncostatin M (OSM), an interleukin-6-family cytokine linked to endothelial activation and inflammation, may provide prognostic information complementary to established tools such as the simplified Pulmonary Embolism Severity Index (sPESI). This prospective single-center cohort study enrolled 88 participants: 44 patients with CTPA-confirmed PE, 22 PE-negative patients, and 22 controls. Serum OSM was measured by ELISA at emergency department presentation. The primary outcome was in-hospital mortality. Contextual between-group comparisons were performed, and the incremental value of OSM beyond sPESI was assessed using parsimonious logistic regression and ROC analysis with DeLong testing. In-hospital mortality among patients with PE was 47.7% (21/44). OSM levels were higher in patients with PE than in PE-negative patients or controls (median, 277.3 vs. 143.8 and 145.8 pg/mL; p < 0.001). Among PE patients, non-survivors had higher OSM levels than survivors (333.4 [267.9–382.8] vs. 253.7 [225.5–292.3] pg/mL; p = 0.004). After adjustment for sPESI, each 100 pg/mL increase in OSM showed a non-significant association with mortality (adjusted OR, 2.40; 95% CI, 0.95–6.07; p = 0.065). Adding OSM to sPESI numerically increased the AUC from 0.717 to 0.789, but this improvement was not significant (ΔAUC = 0.071; p = 0.161). OSM levels were higher among non-survivors with acute PE; however, OSM did not provide statistically significant incremental discrimination beyond sPESI in this cohort. Larger multicenter studies are needed to clarify its prognostic utility.