Key result
Heart and respiratory failure linked to ~35-fold higher in-hospital mortality in cancer-associated PE.
Why the study?
Thromboembolic complications significantly affect mortality in cancer patients, who have a markedly increased risk of venous thromboembolism, prompting the need to identify factors associated with unfavorable prognosis in cancer-associated pulmonary embolism.
Observational (n=108)
No
Odds Ratio: 35.201 (95% CI 1.409–879.32)
p-value: p=0.030
In patients with cancer-associated pulmonary embolism, a history of heart failure, prolonged bed rest, and lower systolic blood pressure are significant predictors of mortality.
Identified prognostic factors may refine VTE risk assessment in cancer; leaves open prospective validation before guiding practice.
Background. Thromboembolic complications in patients with oncological diseases significantly affect the course of the illness and mortality rate, ranking second among the causes of death after the malignant process itself. In cancer patients, the risk of developing venous thromboembolism is markedly increased and, according to current studies, is nine times higher than in the general population. Purpose – to identify factors associated with an unfavorable prognosis in the short-term and long-term periods in patients with pulmonary embolism associated with cancer. Materials and Methods. A prospective analysis of 108 medical records of patients with acute pulmonary embolism and verified oncological disease was conducted. All patients were treated at Kharkiv City Clinical Hospital No. 8 during the period from January 1, 2018, to January 1, 2024. Among the 108 patients with cancer-associated pulmonary embolism, 9.2% experienced a fatal outcome, while 90.7% were discharged with improvement. All patients were divided into two groups: Group I – patients with PE and cancer who were discharged with improvement; Group II – patients with PE and cancer who had a fatal outcome. The mean age of patients in Group II was 65.9 years, while the mean age of survivors was 65.4 years. Results. Analysis of cancer localization revealed that among patients with oncopathology and pulmonary embolism who died, the most frequent tumor sites were the breast (50%) and the prostate. Cancer localizations such as the uterus and ovaries, stomach, and nervous system had an equal impact (10%) on mortality in the studied cohort. Univariate logistic regression analysis demonstrated that the presence of congestive heart failure and respiratory failure in patients with and malignancy was significantly associated with an increased risk of fatal outcome (p < 0.030). Additionally, a lower level of systolic blood pressure (p < 0.007) was accompanied by a higher probability of death. Conclusions. In oncological patients with pulmonary embolism, the mortality rate was associated with a history of congestive heart and respiratory failure, prolonged bed rest for more than 3 days, and advanced age.
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Shylo et al. (2025) conducted an observational in Pulmonary embolism associated with cancer (n=108). Heart and respiratory failure vs. Absence of heart and respiratory failure was evaluated on Fatal outcome (in-hospital mortality) (OR 35.201, 95% CI 1.409-879.320, p=0.030). The presence of heart and respiratory failure in patients with cancer-associated pulmonary embolism was significantly associated with an increased risk of in-hospital mortality (OR 35.201).
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