Track topics on Twitter Track topics that are important to you
Guidelines suggest the use of thrombolytic therapy for acute pulmonary embolism (PE) patients with hypotension who are not at high-risk of bleeding. Data describing the use of thrombolysis in patients with cancer are scarce. The aim of this study was to evaluate the relationship between cancer and the use of thrombolysis for acute PE. The 2013 and 2014 US National Inpatient Sample was used to identify admissions for acute PE. Identified admissions were stratified based on the presence or absence of cancer. Multivariable logistic regression was performed to determine the association between comorbid cancer and the odds of receiving thrombolysis after adjustment for patient- and hospital-level covariates. In those receiving thrombolysis, the association between cancer and in-hospital mortality was determined using logistic regression after adjusting for age ≥ 65 years and sex. We identified 72,546 admissions for acute PE; of which, 14.7% (n = 10,673) had comorbid cancer. A total of 3.4% (n = 2439) of patients received thrombolysis. Upon multivariable adjustment, cancer was associated with decreased odds of receiving thrombolysis (odds ratio = 0.55; 95% confidence interval = 0.48-0.64). When the population was restricted to PE admissions receiving thrombolysis, mortality occurred in 315 (12.9%) admissions; with no difference in in-hospital mortality observed between those with versus without cancer (p = 0.11). In this study of admissions for acute PE, comorbid cancer was associated with decreased odds of receiving thrombolysis. As PE is a common complication among patients with cancer, the risk-benefit profile of thrombolysis in this patient population should be determined.
This article was published in the following journal.
Name: Journal of thrombosis and thrombolysis
Accurate and expeditious diagnosis and treatment of pulmonary embolism in cancer patients improves patient outcomes. D-dimer is often used to rule out pulmonary embolism. However, this test is less ac...
Pulmonary embolism (PE) is the third most common cardiovascular cause of death; systemic thrombolysis is potentially lifesaving treatment in patients presenting with haemodynamic instability. We inves...
Our experience suggests that ultrasound-assisted thrombolysis with the EkoSonic system could be a valid bail-out strategy in cases of massive pulmonary embolism unresponsive to systemic thrombolysis a...
Electrocardiographic (ECG) signs of right ventricular strain could be used as a simple tool to risk-stratify patients with acute pulmonary embolism.
:Pulmonary embolism is a common emergency in the hospital setting. Main line of treatment is anticoagulant therapy. However, patients with right ventricular dysfunction are the subgroup with increased...
To assess the efficacy and safety of endovascular thrombolysis of pulmonary embolism with right ventricular dysfunction with single-dose rtPA
1. To analyze the diagnostic and prognostic value of echocardiographic parameters. 2. Prediction of APE-related 30-day mortality and adverse out comes. 3. The need for rescue thrombo...
Evaluating the safety and outcomes of catheter directed thrombolysis following catheter fragmentation in acute high risk pulmonary embolism
A prospective observational study to evaluate the safety and effectiveness data of catheter-directed therapy (CDT) including percutaneous mechanical thrombectomy (PMT) for treatment of acu...
To determine whether peripheral low dose systemic thrombolysis (PLST) is non-inferior to catheter directed acoustic pulse thrombolysis (ACDT) in improving RV function and reducing pulmonar...
Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.
Respiratory syndrome characterized by the appearance of a new pulmonary infiltrate on chest x-ray, accompanied by symptoms of fever, cough, chest pain, tachypnea, or DYSPNEA, often seen in patients with SICKLE CELL ANEMIA. Multiple factors (e.g., infection, and pulmonary FAT EMBOLISM) may contribute to the development of the syndrome.
Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.
An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.
A morpholine and thiophene derivative that functions as a FACTOR XA INHIBITOR and is used in the treatment and prevention of DEEP-VEIN THROMBOSIS and PULMONARY EMBOLISM. It is also used for the prevention of STROKE and systemic embolization in patients with non-valvular ATRIAL FIBRILLATION, and for the prevention of atherothrombotic events in patients after an ACUTE CORONARY SYNDROME.
Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer th...
Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...