Analysis Of Risk Factors For Death Of Oncologic Complicated With Pulmonary Embolism

Objective: Through the analysis of clinical data of patients with malignant tumor combined with pulmonary embolism,we explored the risk factors of all-cause death in patients with malignant tumor combined with pulmonary embolism during hospitalization.It is hoped that early intervention and preventive treatment on risk factors can improve the prognosis of patients.Methods: A total of 253 patients who were diagnosed with malignant tumor combined with pulmonary embolism in Sichuan Cancer Hospital from January 2017 to June 2022 were included in the study.Clinical data were collected.SPSS 26.0 statistical software was used to process the data.The risk factors for all-cause death were explored by univariate and multivariate logistic regression analysis.P<0.05 was considered as the difference with statistical significance.Results: In this study,56.13% of the patients were male with malignant tumor combined with pulmonary embolism,and the average age was 63(53.5,69)years old.The mortality rate was 7.9%,and the median hospital stay was 15(8,23)days.2.Comparison of general data of patients with malignant tumor complicated with pulmonary embolism: There are significant differences in respiration,pulse,systolic blood pressure,recent infection and syncope between the death group and the survival group(P < 0.05).There was no significant difference in other indicators(P > 0.05).3.Tumor-related data of patients with malignant tumor combined with PE: There were 253 cases of malignant tumor complicated with pulmonary embolism,including 128 cases(50.6%)of respiratory system tumor,48cases(19.4%)of digestive system tumor and 38 cases(15.0%)of gynecological tumor.In the death group,the common types of tumors were lung cancer(70%)and cervical cancer(10%),and there was no significant difference between the two groups in lung cancer,cervical cancer,endometrial cancer,ovarian cancer,breast cancer and liver cancer(P> 0.05).Distant metastasis occurred in 75% cases in the death group and 41.20% cases in the survival group,showing a statistically significant difference between the two groups(P < 0.05).Chemotherapy(46.64%),radiotherapy(28.85%),immunotherapy(4.35%),targeted therapy(20.55%)and surgery(33.20%)were the main methods of tumor treatment.There was no significant difference in anti-tumor treatment between the two groups(P > 0.05).4.In comparison of laboratory tests,WBC,NE,MONO,D-D,PT,APTT,TB,ALT,AST,urea nitrogen,uric acid,and troponin in the death group were significantly higher than those in the survival group.Albumin was significantly lower than that in the survival group,and the difference between the two groups was statistically significant(P < 0.05).5.In the aspect of risk stratification,the differences between the death group and the survival group in high-risk PE were statistically significant.(P < 0.05).There was no difference between the two groups in the comparison of anticoagulant therapy and thromboembolic sites(P > 0.05).6.Multivariate logistic regression analysis showed that uric acid(OR= 1.007,95% CI: 1.003～1.011;P < 0.001),recent infection(OR=4.630,95%CI: 1.099～19.505;P=0.037)and distant metastasis(OR =4.463,95%CI: 1.031～19.312;P=0.045)was an independent risk factor for death during hospitalization.Systolic blood pressure(OR = 0.958,95%CI: 0.934～0.981;P=0.001)was a protective factor for inpatient deaths in patients with malignancy combined with pulmonary embolism.Conclusion: The mortality of malignant tumor combined with pulmonary embolism is 7.9%.Uric acid,recent infection and distant metastasis of tumor are independent risk factors of all-cause death in hospitalized patients with malignant tumor complicated with pulmonary embolism,Systolic blood pressure is a protective factor.