Malignancy and acute pulmonary embolism: risk stratification including the right to left ventricle diameter ratio in 1596 subjects
Department of Radiology
Medical Subject Headings
Pulmonary Embolism; Neoplasms
Cardiovascular Diseases | Neoplasms | Oncology | Radiology | Respiratory Tract Diseases
PURPOSE: To test the hypothesis that subjects with a known malignancy at the time of acute pulmonary embolism (PE) have different clinical characteristics and predictors of 30-day all-cause mortality when compared with subjects with no known malignancy.
MATERIALS AND METHODS: A retrospective (August 2003 to March 2010) cohort of 1596 consecutive positive (for acute PE) computed tomography pulmonary angiograms (CTPAs) performed at a single, large, urban teaching hospital was separated into those from subjects with (n=835) and those from subjects without (n=761) a known malignancy. Clinical characteristics were compared between groups, and a logistic regression model determined predictors of 30-day all-cause mortality for each group.
RESULTS: Subjects with malignancy were older (60.8+/-13.9 vs. 54.5+/-18.8 y, P1.0) had a higher risk of 30-day death only among subjects with no known malignancy at the time of the CTPA (odds ratio=4.08, 95% confidence interval: 1.67-9.96).
CONCLUSIONS: Among subjects who present with acute PE, those with a malignancy had different clinical characteristics and predictors of mortality when compared with the cohort of subjects with no known malignancy. A computed tomography-derived right to left ventricular diameter ratio predicts 30-day all-cause mortality only for those subjects who do not have a malignancy.
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Citation: J Thorac Imaging. 2013 May;28(3):196-201. doi: 10.1097/RTI.0b013e3182870bf9. Link to article on publisher's site
Cai, Bryan; Bedayat, Arash; George, Elizabeth; Hunsaker, Andetta R.; Dill, Karin E.; Rybicki, Frank J.; and Kumamaru, Kanako K., "Malignancy and acute pulmonary embolism: risk stratification including the right to left ventricle diameter ratio in 1596 subjects" (2013). University of Massachusetts Medical School Faculty Publications. 57.