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Unreported incidental pulmonary embolism in patients with cancer : Radiologic natural history and risk of recurrent venous thromboembolism and death

Wiklund, Peder ; Medson, Koshiar and Elf, Johan LU (2023) In Thrombosis Research 224. p.65-72
Abstract

Purpose: To assess the risk of recurrent venous thromboembolism (VTE) and death in patients with unreported cancer-associated incidental pulmonary embolism (iPE). Materials and methods: Matched cohort study on cancer patients with a CT study including the chest between 2014-01-01 and 2019-06-30. Studies were reviewed for unreported iPE, and cases were matched with controls without iPE. Cases and controls were followed for one year, with recurrent VTE and death as outcome events. Results: Of the included 2960 patients, 171 patients had unreported and untreated iPE. While controls had a one-year VTE risk of 8.2 events per 100 person-years, cases with a single subsegmental iPE had a recurrent VTE risk of 20.9 events, and between 52.0 and... (More)

Purpose: To assess the risk of recurrent venous thromboembolism (VTE) and death in patients with unreported cancer-associated incidental pulmonary embolism (iPE). Materials and methods: Matched cohort study on cancer patients with a CT study including the chest between 2014-01-01 and 2019-06-30. Studies were reviewed for unreported iPE, and cases were matched with controls without iPE. Cases and controls were followed for one year, with recurrent VTE and death as outcome events. Results: Of the included 2960 patients, 171 patients had unreported and untreated iPE. While controls had a one-year VTE risk of 8.2 events per 100 person-years, cases with a single subsegmental iPE had a recurrent VTE risk of 20.9 events, and between 52.0 and 72.0 events per 100 person-years for multiple subsegmental iPE and more proximal iPE. In multivariable analysis, multiple subsegmental and more proximal iPE were significantly associated with the risk of recurrent VTE, while single subsegmental iPE was not associated with the risk of recurrent VTE (p = 0.13). In the subgroup of patients (n = 47) with cancer not in the highest Khorana VTE risk category, no metastases and up to three involved vessels, recurrent VTE occurred in two patients (4.7 cases per 100 person-years). There were no significant associations between iPE burden and risk of death. Conclusion: In cancer patients with unreported iPE, iPE burden was associated with the risk of recurrent VTE. However, having a single subsegmental iPE was not associated with the risk of recurrent VTE. There were no significant associations between iPE burden and risk of death.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Artificial intelligence, Neoplasms, Pulmonary embolism, Retrospective studies, Venous thromboembolism
in
Thrombosis Research
volume
224
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:85149759200
  • pmid:36867992
ISSN
0049-3848
DOI
10.1016/j.thromres.2023.02.010
language
English
LU publication?
yes
id
68bf68cc-2647-48f1-b7c3-8bfb9e52a30c
date added to LUP
2023-04-24 14:18:53
date last changed
2024-02-19 18:59:29
@article{68bf68cc-2647-48f1-b7c3-8bfb9e52a30c,
  abstract     = {{<p>Purpose: To assess the risk of recurrent venous thromboembolism (VTE) and death in patients with unreported cancer-associated incidental pulmonary embolism (iPE). Materials and methods: Matched cohort study on cancer patients with a CT study including the chest between 2014-01-01 and 2019-06-30. Studies were reviewed for unreported iPE, and cases were matched with controls without iPE. Cases and controls were followed for one year, with recurrent VTE and death as outcome events. Results: Of the included 2960 patients, 171 patients had unreported and untreated iPE. While controls had a one-year VTE risk of 8.2 events per 100 person-years, cases with a single subsegmental iPE had a recurrent VTE risk of 20.9 events, and between 52.0 and 72.0 events per 100 person-years for multiple subsegmental iPE and more proximal iPE. In multivariable analysis, multiple subsegmental and more proximal iPE were significantly associated with the risk of recurrent VTE, while single subsegmental iPE was not associated with the risk of recurrent VTE (p = 0.13). In the subgroup of patients (n = 47) with cancer not in the highest Khorana VTE risk category, no metastases and up to three involved vessels, recurrent VTE occurred in two patients (4.7 cases per 100 person-years). There were no significant associations between iPE burden and risk of death. Conclusion: In cancer patients with unreported iPE, iPE burden was associated with the risk of recurrent VTE. However, having a single subsegmental iPE was not associated with the risk of recurrent VTE. There were no significant associations between iPE burden and risk of death.</p>}},
  author       = {{Wiklund, Peder and Medson, Koshiar and Elf, Johan}},
  issn         = {{0049-3848}},
  keywords     = {{Artificial intelligence; Neoplasms; Pulmonary embolism; Retrospective studies; Venous thromboembolism}},
  language     = {{eng}},
  pages        = {{65--72}},
  publisher    = {{Elsevier}},
  series       = {{Thrombosis Research}},
  title        = {{Unreported incidental pulmonary embolism in patients with cancer : Radiologic natural history and risk of recurrent venous thromboembolism and death}},
  url          = {{http://dx.doi.org/10.1016/j.thromres.2023.02.010}},
  doi          = {{10.1016/j.thromres.2023.02.010}},
  volume       = {{224}},
  year         = {{2023}},
}