Mai, AS, Matetić, A, Elgendy, IY, Mattei, JL, Kotronias, RA, Sun, LY, Yong, JH, Bagur, R, Van Spall, HGC and Mamas, MA (2022) The Association Between Cancer Diagnosis, Care, and Outcomes in 1 Million Patients Hospitalized for Acute Pulmonary Embolism. International Journal of Cardiology. ISSN Elsevier

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Abstract

OBJECTIVES: To evaluate the clinical care provided to cancer patients hospitalized for acute pulmonary embolism (PE), as well as the association between type of cancer, in-hospital care, and clinical outcomes. METHODS: This study examined the in-hospital care (systemic thrombolysis, catheter-directed thrombolysis, and surgical thrombectomy/embolectomy) and clinical outcomes (mortality, major bleeding, and hemorrhagic stroke) among adults hospitalized due to acute PE between October 2015 to December 2018 using the National Inpatient Sample (NIS). Multivariable logistic regression analysis was used to determine adjusted odds ratios (aOR) with 95% confidence interval (95% CI). RESULTS: Of 1,090,130 hospital records included in the analysis, 216,825 (19.9%) had current cancer diagnoses, including lung (4.7%), hematological (2.5%), colorectal (1.6%), breast (1.3%), prostate (0.8%), and 'other' cancer (9.0%). Cancer patients had lower adjusted odds of receiving systemic thrombolysis, catheter-directed therapy, and surgical thrombectomy/embolectomy compared with their non-cancer counterparts (P<0.001), except for systemic thrombolysis (aOR 0.96, 95% CI 0.85-1.09, P=0.553) and catheter-directed therapy (aOR 0.82, 95% CI 0.67-1.00, P=0.053) for prostate cancer. Cancer patients had greater odds of mortality (P<0.05). Lung cancer patients had the highest odds of mortality (aOR 2.68, 95% CI 2.61-2.76, P<0.001) and hemorrhagic stroke (aOR 1.75, 95% CI 1.61-1.90, P<0.001), while colorectal cancer patients had the greatest odds of bleeding (aOR 2.04, 95% CI 1.94-2.15, P<0.001). CONCLUSION: Among those hospitalized for PE, cancer diagnoses were associated with lower odds of invasive management and poorer in-hospital outcomes, with metastatic status being an especially important determinant. Appropriateness of care could not be assessed in this study.

Item Type: Article
Additional Information: © 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 13 Oct 2022 07:50
Last Modified: 13 Oct 2022 07:50
URI: https://eprints.keele.ac.uk/id/eprint/11496

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