Are the Clinical and Radiological Characteristics of Pulmonary Embolism Differential in Patients with Cancer?

Abstract

Background: In general, it is known that many cancers and chemotherapy regimens administered to prevent cancer increase the tendency for thrombosis by disrupting hemostasis physiology. In this study, the prognostic differences between pulmonary embolism (PE) in patients diagnosed with cancer and those without a cancer diagnosis were investigated. Materials and Methods: The records of patients diagnosed with PE in our clinic between December 2021 and January 2023 were retrospectively examined. Patients were divided into 2 groups: those with and without a history of cancer. Clinical, demographic, radiological, and laboratory characteristics of the patients in both groups were compared. Pulmonary Embolism Severity Index (PESI) score was used for the prognostic evaluation of PE. For the classification of the severity of PE and early mortality assessment (EMD) patients were stratified into low, moderate-low, moderate-high, and high-risk categories. The data of these two groups were compared. Results: A total of 108 patients, with a mean age of 65.5±18 years, were included in the study. Of these patients, 30 (27.7%) (Group 1) had a history of cancer, and 78 (72.3%) (Group 2) had no history of cancer. The mean duration of hospitalization was 7.3±5.4 days in Group 1 and 9.7±5.2 days in Group 2 (p<0.05). No significant difference was observed in D-dimer, brain natriuretic peptide, and troponin values (p>0.05). Thoracic computed tomography-angiography findings of both groups were also similar (p>0.05). In Group 1; mean PESI score and rate of the number of patients PESI-III and above were significantly higher (p<0.05). In terms of EMD, the rate of high-risk patients and incidence of hemodynamic instability were significantly higher in Group 1 (p<0.05). Concerning the 30 day mortality, the rate of number of patients in Group 1 was significantly higher (p<0.05). Conclusion: The presence of an additional cancer diagnosis did not have a notable impact on the radiological and laboratory parameters of PE; however, it did significantly change the early mortality associated with PE.