4340 - Short-term outcomes of cancer patients with pulmonary embolism according to the setting (hospital-acquired vs. outpatient) at diagnosis.

Background

Pulmonary embolism (PE) is a common condition in patients with cancer, having a wide spectrum of clinical presentation (from acute life-threatening to truly asymptomatic incidental events). The aim of this study was to assess the prognostic relevance of the variable ‘setting’ (hospital-acquired vs. outpatient) at PE diagnosis.

Methods

Multicenter observational ongoing registry of consecutive patients with cancer-associated PE (2005-2018) including incidental and acute symptomatic events. The main outcome measured was the rate of overall and PE-specific 30-day mortality. Secondary outcomes were: rates of 30-day major bleeding (MB) and venous thromboembolism (VTE) recurrence.

Results

We included a total of 617 patients (61.6% male; median age 65 + 11.4 years; range 19-91 years) including N = 522 (85%) outpatients and N = 95 (15%) inpatients at PE diagnosis. The most frequent primary tumors were: lung 32%, colorectal 14%, urologic 13%, upper GI 12%, breast 9%, gynecologic 6% and other 9%). Most of the patients (79%) had metastatic cancer and nearly half (47%) were receiving chemotherapy.The PE was incidentally found in 54% of the cases. Overall 30-day mortality occurred in 95 patients (15% of the cohort), being greater in inpatients compared to outpatients (30% vs. 13%; p < 0.0001). Only 13 patients presented PE-related mortality (3% of the cohort), with no significant differences according to the setting at PE diagnosis (3.2% in inpatients vs. 1.7% in outpatients; p = 0.352). Similarly, there were no differences in 30-day MB (7.4% in inpatients vs. 4.4% in outpatients; p = 0.217) or VTE recurrence (4.2% in inpatients vs. 3.3% in outpatients; p = 0.637) according to the setting at PE diagnosis.

Conclusions

Hospital-acquired PE in cancer patients was associated with a greater overall 30-day mortality compared to outpatients at PE diagnosis. This finding may be relevant for the development of PE risk-assessment models in this setting.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hospital Clínic de Barcelona.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.