Detalle Publicación


Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study.

Autores: Font, C. (Autor de correspondencia); Carmona Bayonas, A.; Beato, C.; Reig,O.; Sáez, A.; Jiménez Fonseca, P.; Plasencia, J. M.; Calvo Temprano, D.; Sanchez, M.; Benegas, M.; Biosca, M.; Varona, D.; Vicente, M. A.; Faez, L.; Solís, M. P.; de la Haba, I.; Antonio, M.; Madridano, O.; Castañón Álvarez, Eduardo; Martinez, M. J.; Marchena, P.; Ramchandani, A.; Dominguez, A.; Puerta, A.; Martinez de la Haza, D.; Pueyo, J.; Hernandez, S.; Fernandez Plaza, A.; Martinez Encarnacion, L.; Martin, M.; Marin, G.; Ayala, F.; Vicente, V.; Otero, R.
ISSN: 1399-3003
Volumen: 49
Número: 1
Páginas: 1600282
Fecha de publicación: 2017
The study aimed to identify predictors of overall 30-day mortality in cancer patients with pulmonary embolism including suspected pulmonary embolism (SPE) and unsuspected pulmonary embolism (UPE) events. Secondary outcomes included 30- and 90-day major bleeding and venous thromboembolism (VTE) recurrence.The study cohort included 1033 consecutive patients with pulmonary embolism from the multicentre observational ambispective EPIPHANY study (March 2006-October 2014). A subgroup of 497 patients prospectively assessed for the study were subclassified into three work-up scenarios (SPE, truly asymptomatic UPE and UPE with symptoms) to assess outcomes.The overall 30-day mortality rate was 14%. The following variables were associated with the overall 30-day mortality on multivariate analysis: VTE history, upper gastrointestinal cancers, metastatic disease, cancer progression, performance status, arterial hypotension <100 mmHg, heart rate >110 beats·min-1, basal oxygen saturation <90% and SPE (versus overall UPE).The overall 30-day mortality was significantly lower in patients with truly asymptomatic UPE events (3%) compared with those with UPE-S (20%) and SPE (21%) (p<0.0001). Thirty- and 90-day VTE recurrence and major bleeding rates were similar in all the groups.In conclusion, variables associated with the severity of cancer and pulmonary embolism were associated with short-term mortality. Our findings may help to develop pulmonary embolism risk-assessment models in this setting