Pulmonary embolism in non-brain tumor patients after surgery—a retrospective study in China

Abstract

BackgroundThe incidence rate of pulmonary emboli (PE) is high in tumor patients; however, the morbidity and mortality associated with the development of PE after tumor surgery are unknown. We studied the clinical profiles and outcomes of patients with PE after non-brain tumor surgery.MethodsWe retrospectively screened 55,967 patients who underwent non-brain tumor surgery at the Peking University Cancer Hospital from January 2008 to June 2015. Among them, 76 patients who were diagnosed with PE were enrolled in our study. Factors impacting the overall survival at 90 days were analyzed. A Kaplan-Meier curve was plotted for time to death or until day 90. Cox proportional hazard modeling was performed for univariate- and multivariate-adjusted factor analyses.ResultsThe morbidity rate was approximately 135.8 per 100,000 non-brain tumor surgery patients (possibly underestimated). When treated, seven patients had major bleeding, and 14 patients had clinically relevant non-major bleeding, which represented 9.2 and 18.4% of all the patients, respectively. The 3-month overall mortality rate was 11.8% in our study. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and platelet distribution width (PDW) were independent risk factors for the prognosis of PE after non-brain surgery (P values of 0.001 and 0.016, respectively).ConclusionsTreatment of PE in non-brain tumor surgical patients remained a challenge due to the high bleeding rate. The APACHE II score and PDW were independent prognostic factors of survival in patients with PE after non-brain tumor surgery; however, the study power was limited.

The risk factors on the prognosis of pulmonary embolism in tumor patients after the thoracic and abdominal surgery

“…Therapy for patients with PE after surgery was more complicated than for PE patients without surgery due to the high-risk rate of bleeding (6). The aim of this study was to…”

The ICU-venous thromboembolism score and tumor grade can predict inhospital venous thromboembolism occurrence in critical patients with tumors

“…VTE was defined as deep vein thrombosis (DVT), pulmonary embolism (PE), or both. A variety of factors contribute to thrombotic risk in tumor patients, apart from patient-specific factors (age, sex, ethnicity, high body mass index, platelet count, platelet distribution width, hyperlipidemia, ABO blood type, comorbidities) [4][5][6][7][8][9][10] and tumor-specific factors (tumor type, anatomical location, tumor load, gene mutations, tumor stage, and pathologic grade) [1,7,8,11,12]; therapeutic measures, such as chemotherapy, the use of red cell or platelet transfusions, high-risk surgery, indwelling catheter, invasive mechanical ventilation, total parenteral nutrition (TPN), and so on, constitute the other risk factors of VTE [4,8,13].…”

Prognostic role of the preoperative neutrophil-to-lymphocyte ratio and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism

“…Although the methods of diagnosis and treatment of PAPE have been continuously developed in recent years, including imaging diagnosis, interventional surgery and medicinal chemotherapy, the overall survival rate of patients with PAPE is extremely low. It was reported that the shortterm mortality of patients with PAPE was between 10 and 23.1% [5][6][7][8][9]. Therefore, identifying the preoperative risk factors associated with mortality may help to direct more aggressive treatment strategies, such as fibrinolytic therapy, towards patients who will derive the greatest benefit.…”