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Pulmoner Embolisi Olan Kanser Hastalarında Mortaliteye Etki Eden Faktörler

Year 2024, Volume: 10 Issue: 3, 500 - 505, 19.09.2024
https://doi.org/10.53394/akd.1341383

Abstract

ÖZ
Amaç: Bu makalenin amacı, pulmoner embolisi (PE) olan kanser hastalarında mortaliteye etki eden faktörleri araştırmaktır.
Gereç ve Yöntemler: Bu çalışma retrospektif bir kohort çalışmadır. Çalışma popülasyonu, Ocak 2018 ile Aralık 2022 tarihleri arasında XXX Üniversitesi Hastanesi Göğüs Hastalıkları Kliniğinde yatarak tedavi gören PE tanısı konmuş kanser hastalarını içermektedir. Bu hastalardan malignitesi olanlar ile benzer demografik özelliklere sahip malignitesi olmayan hastalar troponin , probnp , trombosit , derin ven trombozu varlığı, ek komorbidite varlığı, hastanede kalış süresi, yoğun bakım ünitesine yatış oranı ve mortalite açısından karşılaştırılmıştır.
Bulgular: Çalışmaya malignite tanısı olan 73 hasta ile benzer demografik verilere sahip malignitesi olmayan 74 hasta dahil edildi. Çalışmaya dahil edilen hastaların %53,1 (78) erkek olup, yaş ortalaması 63,7± 15,8 olarak saptandı. Kanser hastalarının organ ve/veya sistemlere göre dağılımı akciğer kanseri (n=31), gastrointestinal kanser (n=17), genitoüriner kanser (n=10), meme kanseri (n=6), santral sinir sistemi tümörleri (n=6), hematolojik maligniteler (n=3) ve tiroit kanseri (n=1) şeklindeydi. Malign hastaların %65,8 (48)’i aktif olarak kemoterapi ve/veya radyoterapi alıyordu ve %43,8 (n=32)’nin uzak organ metastazı vardı. Malignitesi olanlar PE hastalarının %48 (35) non-masif, %26,0 (19) sub-masif ve 26,0 (19) masif PE kliniğine sahipti. Kanser hastaları PE tanısını malignite tanısı aldıktan ortalama 13,67 ay sonra almıştı. Malign hastalar ile non-malign hastalar karşılaştırıldığında, malign hastaların son 6 ay içinde hastaneye yatış oranı ve derin ven trombozu (DVT) saptanma oranı non-malign hastalara göre daha yüksek bulundu (P değerleri sırasıyla p<0,001) (p=0,037)) .
Sonuç: PE ile hastaneye yatan malign hastalarda DVT oranı ve son 6 ayda hastaneye yatış oranı non malign PE hastalarına göre daha yüksektir.

References

  • 1. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 2014; 35(41):2873-926.
  • 2. Biedka M, Ziółkowska E, Windorbska W. Acute pulmonary embolus in the course of cancer. Contemp Oncol 2012; 16(5):388-93.
  • 3. Şahan E, Tüfekcioglu O. Cancer and Acute Pulmonary Embolism. Turk Klin Kardiyol Ozel Derg 2016; 8:154-6.
  • 4. Sanchez O, Trinquart L, Caille V, Couturaud F, Pacouret G, Meneveau N, Verschuren F, Roy PM, Parent F, Righini M, Perrier A, Lorut C, Tardy B, Benoit MO, Chatellier G, Meyer G. Prognostic factors for pulmonary embolism: the prep study, a prospective multicenter cohort study. Am J Respir Crit Care Med 2010; 181(2):168-73.
  • 5. Blom JW, Doggen CJM, Osanto S, Rosendaal FR. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 2005; 293(6):715-22.
  • 6. Lee JE , Kim HR, Lee SM , Yim JJ, Yoo CG, Kim YW, Han SK, Shim YS, Yang SC. Clinical characteristics of pulmonary embolism with underlying malignancy. Korean J Intern Med 2010; 25(1):66-70.
  • 7. Chew HK, Wun T, Harvey D, Zhou H, White RH. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med 2006; 166(4):458-64.
  • 8. Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? J R Soc Med 1989; 82(4):203-5.
  • 9. Sakuma M , Nakamura M, Yamada N, Ota S, Shirato K, Nakano T, Ito M, Kobayashi T. Venous thromboembolism: deep vein thrombosis with pulmonary embolism, deep vein thrombosis alone, and pulmonary embolism alone. Circ J Off J Jpn Circ Soc 2009; 73(2):305-9.
  • 10. Karippot A, Shaaban HS, Maroules M, Guron G. The Clinical Characteristics of Pulmonary Embolism in Patients with Malignancy: A Single Medical Institutional Experience. North Am J Med Sci 2012; 4(11):600-4.

Factors Influencing Mortality in Cancer Patients with Pulmonary Embolism

Year 2024, Volume: 10 Issue: 3, 500 - 505, 19.09.2024
https://doi.org/10.53394/akd.1341383

Abstract

Abstract
Objective: The aim of this article is to investigate the factors influencing mortality in cancer patients with pulmonary embolism (PE).
Material and Methods: This study is a retrospective cohort study. The study population includes cancer patients diagnosed with pulmonary embolism who were hospitalized in the Department of Chest Diseases at XXX University Hospital between January 2018 and December 2022. Patients with malignancy were compared with patients without malignancy but similar demographic characteristics in terms of troponin, probnp, platelet count, presence of deep vein thrombosis, presence of additional comorbidities, length of hospital stay, intensive care unit admission rate, and mortality.
Results: The study included 73 patients with malignancy and 74 patients without malignancy with similar demographic data. Among the included patients, 53.1% (78) were male, and the mean age was 63.7±15.8. The distribution of cancer patients according to organ and/or systems was as follows: lung cancer (n=31), gastrointestinal cancer (n=17), genitourinary cancer (n=10), breast cancer (n=6), central nervous system tumors (n=6), hematological malignancies (n=3), and thyroid cancer (n=1). Among the malign patients, 65.8% (48) were actively receiving chemotherapy and/or radiotherapy, and 43.8% (n=32) had distant organ metastasis. Malignant patients had non-massive PE in 48% (35), sub-massive PE in 26.0% (19), and massive PE in 26.0% (19) of cases. Cancer patients were diagnosed with PE a mean of 13.67 months after their cancer diagnosis. When compared with non-malignant patients, malignant patients had higher rates of hospitalization within the last 6 months and detection of deep vein thrombosis (DVT) (P values were p<0.001 and p=0.037, respectively).
Conclusion: Malignant patients hospitalized with PE have higher rates of DVT and hospitalization within the last 6 months compared to non-malignant PE patients.

References

  • 1. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 2014; 35(41):2873-926.
  • 2. Biedka M, Ziółkowska E, Windorbska W. Acute pulmonary embolus in the course of cancer. Contemp Oncol 2012; 16(5):388-93.
  • 3. Şahan E, Tüfekcioglu O. Cancer and Acute Pulmonary Embolism. Turk Klin Kardiyol Ozel Derg 2016; 8:154-6.
  • 4. Sanchez O, Trinquart L, Caille V, Couturaud F, Pacouret G, Meneveau N, Verschuren F, Roy PM, Parent F, Righini M, Perrier A, Lorut C, Tardy B, Benoit MO, Chatellier G, Meyer G. Prognostic factors for pulmonary embolism: the prep study, a prospective multicenter cohort study. Am J Respir Crit Care Med 2010; 181(2):168-73.
  • 5. Blom JW, Doggen CJM, Osanto S, Rosendaal FR. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 2005; 293(6):715-22.
  • 6. Lee JE , Kim HR, Lee SM , Yim JJ, Yoo CG, Kim YW, Han SK, Shim YS, Yang SC. Clinical characteristics of pulmonary embolism with underlying malignancy. Korean J Intern Med 2010; 25(1):66-70.
  • 7. Chew HK, Wun T, Harvey D, Zhou H, White RH. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med 2006; 166(4):458-64.
  • 8. Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? J R Soc Med 1989; 82(4):203-5.
  • 9. Sakuma M , Nakamura M, Yamada N, Ota S, Shirato K, Nakano T, Ito M, Kobayashi T. Venous thromboembolism: deep vein thrombosis with pulmonary embolism, deep vein thrombosis alone, and pulmonary embolism alone. Circ J Off J Jpn Circ Soc 2009; 73(2):305-9.
  • 10. Karippot A, Shaaban HS, Maroules M, Guron G. The Clinical Characteristics of Pulmonary Embolism in Patients with Malignancy: A Single Medical Institutional Experience. North Am J Med Sci 2012; 4(11):600-4.
There are 10 citations in total.

Details

Primary Language Turkish
Subjects Chest Diseases
Journal Section Research Article
Authors

Bedia Karaçadır 0000-0003-4882-3201

Fatih Üzer 0000-0001-9318-0458

Tülay Özdemir 0000-0002-7012-3298

Early Pub Date September 13, 2024
Publication Date September 19, 2024
Submission Date August 11, 2023
Published in Issue Year 2024 Volume: 10 Issue: 3

Cite

APA Karaçadır, B., Üzer, F., & Özdemir, T. (2024). Pulmoner Embolisi Olan Kanser Hastalarında Mortaliteye Etki Eden Faktörler. Akdeniz Tıp Dergisi, 10(3), 500-505. https://doi.org/10.53394/akd.1341383