Clinical features and risk factors for poor prognosis in malignant tumor patients with pulmonary embolism: a case control study

恶性肿瘤合并肺栓塞患者预后不良的临床特征和危险因素:一项病例对照研究

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Abstract

BACKGROUND: Pulmonary embolism (PE) is a significant cause of death in cancer patients. Although there are many reports on the clinical features and In-hospital prognosis for PE, but few studies on malignant tumors combined with pulmonary embolism. Early identification of high-risk populations, enhanced monitoring, and targeted therapeutic measures are crucial for improving patient prognosis. We conducted this study to identify reliable prognostic indicators through the analysis of real-world data. METHODS: A total of 471 patients of malignant tumors complicated with PE were divided into two groups: (1) PE with poor prognosis group (n = 146). (2) PE without poor prognosis group (n = 325). Clinical characteristics, laboratory parameters and adverse prognostic events were recorded and analyzed. RESULTS: High diastolic blood pressure (Odds Ratio [OR] = 1.819, 95% confidence interval [CI]: 1.144–2.893, p = 0.011), myoglobin (MYO) (OR = 3.283, 95% CI: 2.016–5.347, p < 0.001), procalcitonin (PCT) (OR = 2.530, 95% CI: 1.581–4.049, p < 0.001), pleural effusion (OR = 1.618, 95% CI: 1.013–2.584, p = 0.044) and invasive surgery (OR = 2.339, 95% CI: 1.471–3.719, p < 0.001) were found to be independent risk factors for poor prognosis in malignant tumor patients with PE. The ROC curve analysis showed that the area under the curve (AUC) for MYO and PCT were 0.683 and 0.657, respectively. The combined predictive value of MYO and PCT was 0.704. CONCLUSION: High diastolic blood pressure, MYO, PCT, pleural effusion, invasive surgery were proved to be independent risk factors for poor prognosis in malignant tumor patients with PE. In biomarkers, the indicator of MYO combined with PCT shows the highest predictive value.

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