Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study
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) recur...
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| Veröffentlicht in: | The European respiratory journal 2017-01, Vol.49 (1), p.1600282-1600282 |
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| creator | Font, Carme Carmona-Bayonas, Alberto Beato, Carmen Reig, Òscar Sáez, Antonia Jiménez-Fonseca, Paula Plasencia, Juana M Calvo-Temprano, David Sanchez, Marcelo Benegas, Mariana Biosca, Mercedes Varona, Diego Vicente, Maria Angeles Faez, Laura Solís, Maria Del Pilar de la Haba, Irma Antonio, Maite Madridano, Olga Castañon, Eduardo Martinez, María Jose Marchena, Pablo Ramchandani, Avinash Dominguez, Angel Puerta, Alejandro Martinez de la Haza, David Pueyo, Jesus Hernandez, Susana Fernandez-Plaza, Angela Martinez-Encarnacion, Lourdes Martin, Mar Marin, Gema Ayala, Francisco Vicente, Vicente Otero, Remedios |
| description | 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 110 beats·min
, basal oxygen saturation |
| doi_str_mv | 10.1183/13993003.00282-2016 |
| format | Article |
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, 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.</description><identifier>ISSN: 0903-1936</identifier><identifier>EISSN: 1399-3003</identifier><identifier>DOI: 10.1183/13993003.00282-2016</identifier><identifier>PMID: 28052954</identifier><language>eng</language><publisher>England: European Respiratory Society Journals Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bleeding ; Cancer ; Cohort Studies ; Embolism ; Embolisms ; Female ; Health risk assessment ; Heart rate ; Hemorrhage - epidemiology ; Humans ; Hypotension ; Logistic Models ; Lung cancer ; Male ; Metastases ; Middle Aged ; Mortality ; Multivariate Analysis ; Neoplasms - complications ; Neoplasms - mortality ; Pulmonary arteries ; Pulmonary Embolism - diagnostic imaging ; Pulmonary Embolism - epidemiology ; Pulmonary embolisms ; Risk Assessment ; Risk Factors ; Spain - epidemiology ; Thromboembolism ; Time Factors ; Tomography, X-Ray Computed ; Venous Thromboembolism - diagnostic imaging ; Venous Thromboembolism - epidemiology ; Young Adult</subject><ispartof>The European respiratory journal, 2017-01, Vol.49 (1), p.1600282-1600282</ispartof><rights>Copyright ©ERS 2017.</rights><rights>Copyright European Respiratory Society Journals Ltd. Jan 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-da9bf24e07a16389a87a007413821db93c9023e358bb3298e6351a274d98fd113</citedby><cites>FETCH-LOGICAL-c411t-da9bf24e07a16389a87a007413821db93c9023e358bb3298e6351a274d98fd113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28052954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Font, Carme</creatorcontrib><creatorcontrib>Carmona-Bayonas, Alberto</creatorcontrib><creatorcontrib>Beato, Carmen</creatorcontrib><creatorcontrib>Reig, Òscar</creatorcontrib><creatorcontrib>Sáez, Antonia</creatorcontrib><creatorcontrib>Jiménez-Fonseca, Paula</creatorcontrib><creatorcontrib>Plasencia, Juana M</creatorcontrib><creatorcontrib>Calvo-Temprano, David</creatorcontrib><creatorcontrib>Sanchez, Marcelo</creatorcontrib><creatorcontrib>Benegas, Mariana</creatorcontrib><creatorcontrib>Biosca, Mercedes</creatorcontrib><creatorcontrib>Varona, Diego</creatorcontrib><creatorcontrib>Vicente, Maria Angeles</creatorcontrib><creatorcontrib>Faez, Laura</creatorcontrib><creatorcontrib>Solís, Maria Del Pilar</creatorcontrib><creatorcontrib>de la Haba, Irma</creatorcontrib><creatorcontrib>Antonio, Maite</creatorcontrib><creatorcontrib>Madridano, Olga</creatorcontrib><creatorcontrib>Castañon, Eduardo</creatorcontrib><creatorcontrib>Martinez, María Jose</creatorcontrib><creatorcontrib>Marchena, Pablo</creatorcontrib><creatorcontrib>Ramchandani, Avinash</creatorcontrib><creatorcontrib>Dominguez, Angel</creatorcontrib><creatorcontrib>Puerta, Alejandro</creatorcontrib><creatorcontrib>Martinez de la Haza, David</creatorcontrib><creatorcontrib>Pueyo, Jesus</creatorcontrib><creatorcontrib>Hernandez, Susana</creatorcontrib><creatorcontrib>Fernandez-Plaza, Angela</creatorcontrib><creatorcontrib>Martinez-Encarnacion, Lourdes</creatorcontrib><creatorcontrib>Martin, Mar</creatorcontrib><creatorcontrib>Marin, Gema</creatorcontrib><creatorcontrib>Ayala, Francisco</creatorcontrib><creatorcontrib>Vicente, Vicente</creatorcontrib><creatorcontrib>Otero, Remedios</creatorcontrib><creatorcontrib>Asociación para la Investigación de la Enfermedad Tromboembólica de la región de Murcia</creatorcontrib><title>Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>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
, 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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bleeding</subject><subject>Cancer</subject><subject>Cohort Studies</subject><subject>Embolism</subject><subject>Embolisms</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart rate</subject><subject>Hemorrhage - epidemiology</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Logistic Models</subject><subject>Lung cancer</subject><subject>Male</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - mortality</subject><subject>Pulmonary arteries</subject><subject>Pulmonary Embolism - diagnostic imaging</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary embolisms</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Spain - epidemiology</subject><subject>Thromboembolism</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Venous Thromboembolism - diagnostic imaging</subject><subject>Venous Thromboembolism - epidemiology</subject><subject>Young Adult</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1rFTEUhoMo9lr9BYIE3HQzNSdnPhJ35VJtoWgX7cJVyGTOcKfMTMZ8IN36yzv3tlVw5Sqcl-c9kPMw9h7EKYDCT4BaoxB4KoRUspAC6hdss0-LffySbYQWWIDG-oi9ifFOrESJ8JodSSUqqatyw35vx2EenB15TzblQJHbueNx50MqEoWJ-5ycn9bc99zZ2VHgi00DzSnyX0Pa8ZjjQi5Rd2jm-e-85HHysw33nKbWj0OcPvO0I35-fXl9cfbtB48pd_dv2avejpHePb3H7PbL-c32orj6_vVye3ZVuBIgFZ3VbS9LEo2FGpW2qrFCNCWgktC1Gp0WEgkr1bYotaIaK7CyKTut-g4Aj9nJ494l-J-ZYjLTEB2No53J52hA1QpRyLL5D7SqGg0SxYp-_Ae98znM60cMaIV6PfOBwkfKBR9joN4sYZjWyxgQZm_TPNs0B5tmb3NtfXjanduJuj-dZ334AOlKmag</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Font, Carme</creator><creator>Carmona-Bayonas, Alberto</creator><creator>Beato, Carmen</creator><creator>Reig, Òscar</creator><creator>Sáez, Antonia</creator><creator>Jiménez-Fonseca, Paula</creator><creator>Plasencia, Juana M</creator><creator>Calvo-Temprano, David</creator><creator>Sanchez, Marcelo</creator><creator>Benegas, Mariana</creator><creator>Biosca, Mercedes</creator><creator>Varona, Diego</creator><creator>Vicente, Maria Angeles</creator><creator>Faez, Laura</creator><creator>Solís, Maria Del Pilar</creator><creator>de la Haba, Irma</creator><creator>Antonio, Maite</creator><creator>Madridano, Olga</creator><creator>Castañon, Eduardo</creator><creator>Martinez, María Jose</creator><creator>Marchena, Pablo</creator><creator>Ramchandani, Avinash</creator><creator>Dominguez, Angel</creator><creator>Puerta, Alejandro</creator><creator>Martinez de la Haza, David</creator><creator>Pueyo, Jesus</creator><creator>Hernandez, Susana</creator><creator>Fernandez-Plaza, Angela</creator><creator>Martinez-Encarnacion, Lourdes</creator><creator>Martin, Mar</creator><creator>Marin, Gema</creator><creator>Ayala, Francisco</creator><creator>Vicente, Vicente</creator><creator>Otero, Remedios</creator><general>European Respiratory Society Journals Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20170101</creationdate><title>Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study</title><author>Font, Carme ; Carmona-Bayonas, Alberto ; Beato, Carmen ; Reig, Òscar ; Sáez, Antonia ; Jiménez-Fonseca, Paula ; Plasencia, Juana M ; Calvo-Temprano, David ; Sanchez, Marcelo ; Benegas, Mariana ; Biosca, Mercedes ; Varona, Diego ; Vicente, Maria Angeles ; Faez, Laura ; Solís, Maria Del Pilar ; de la Haba, Irma ; Antonio, Maite ; Madridano, Olga ; Castañon, Eduardo ; Martinez, María Jose ; Marchena, Pablo ; Ramchandani, Avinash ; Dominguez, Angel ; Puerta, Alejandro ; Martinez de la Haza, David ; Pueyo, Jesus ; Hernandez, Susana ; Fernandez-Plaza, Angela ; Martinez-Encarnacion, Lourdes ; Martin, Mar ; Marin, Gema ; Ayala, Francisco ; Vicente, Vicente ; Otero, Remedios</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-da9bf24e07a16389a87a007413821db93c9023e358bb3298e6351a274d98fd113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bleeding</topic><topic>Cancer</topic><topic>Cohort Studies</topic><topic>Embolism</topic><topic>Embolisms</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart rate</topic><topic>Hemorrhage - 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Academic</collection><jtitle>The European respiratory journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Font, Carme</au><au>Carmona-Bayonas, Alberto</au><au>Beato, Carmen</au><au>Reig, Òscar</au><au>Sáez, Antonia</au><au>Jiménez-Fonseca, Paula</au><au>Plasencia, Juana M</au><au>Calvo-Temprano, David</au><au>Sanchez, Marcelo</au><au>Benegas, Mariana</au><au>Biosca, Mercedes</au><au>Varona, Diego</au><au>Vicente, Maria Angeles</au><au>Faez, Laura</au><au>Solís, Maria Del Pilar</au><au>de la Haba, Irma</au><au>Antonio, Maite</au><au>Madridano, Olga</au><au>Castañon, Eduardo</au><au>Martinez, María Jose</au><au>Marchena, Pablo</au><au>Ramchandani, Avinash</au><au>Dominguez, Angel</au><au>Puerta, Alejandro</au><au>Martinez de la Haza, David</au><au>Pueyo, Jesus</au><au>Hernandez, Susana</au><au>Fernandez-Plaza, Angela</au><au>Martinez-Encarnacion, Lourdes</au><au>Martin, Mar</au><au>Marin, Gema</au><au>Ayala, Francisco</au><au>Vicente, Vicente</au><au>Otero, Remedios</au><aucorp>Asociación para la Investigación de la Enfermedad Tromboembólica de la región de Murcia</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study</atitle><jtitle>The European respiratory journal</jtitle><addtitle>Eur Respir J</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>49</volume><issue>1</issue><spage>1600282</spage><epage>1600282</epage><pages>1600282-1600282</pages><issn>0903-1936</issn><eissn>1399-3003</eissn><abstract>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
, 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.</abstract><cop>England</cop><pub>European Respiratory Society Journals Ltd</pub><pmid>28052954</pmid><doi>10.1183/13993003.00282-2016</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0903-1936 |
| ispartof | The European respiratory journal, 2017-01, Vol.49 (1), p.1600282-1600282 |
| issn | 0903-1936 1399-3003 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1868330247 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Bleeding Cancer Cohort Studies Embolism Embolisms Female Health risk assessment Heart rate Hemorrhage - epidemiology Humans Hypotension Logistic Models Lung cancer Male Metastases Middle Aged Mortality Multivariate Analysis Neoplasms - complications Neoplasms - mortality Pulmonary arteries Pulmonary Embolism - diagnostic imaging Pulmonary Embolism - epidemiology Pulmonary embolisms Risk Assessment Risk Factors Spain - epidemiology Thromboembolism Time Factors Tomography, X-Ray Computed Venous Thromboembolism - diagnostic imaging Venous Thromboembolism - epidemiology Young Adult |
| title | Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T05%3A20%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20features%20and%20short-term%20outcomes%20of%20cancer%20patients%20with%20suspected%20and%20unsuspected%20pulmonary%20embolism:%20the%20EPIPHANY%20study&rft.jtitle=The%20European%20respiratory%20journal&rft.au=Font,%20Carme&rft.aucorp=Asociaci%C3%B3n%20para%20la%20Investigaci%C3%B3n%20de%20la%20Enfermedad%20Tromboemb%C3%B3lica%20de%20la%20regi%C3%B3n%20de%20Murcia&rft.date=2017-01-01&rft.volume=49&rft.issue=1&rft.spage=1600282&rft.epage=1600282&rft.pages=1600282-1600282&rft.issn=0903-1936&rft.eissn=1399-3003&rft_id=info:doi/10.1183/13993003.00282-2016&rft_dat=%3Cproquest_cross%3E1983929530%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1983929530&rft_id=info:pmid/28052954&rfr_iscdi=true |