Disparities in the Outcomes of Acute Pulmonary Embolism in Hospitalized Patients with Hematologic Malignancy and Solid Tumor Evidence from the National Inpatient Sample 2016-2018
This study aimed to compare the clinical burden and healthcare utilization outcomes of hematologic versus solid malignancies in patients hospitalized with acute pulmonary embolism (PE). This population-based, retrospective study extracted and analyzed the discharge data from the 2016-2018 US Nationa...
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Published in | International Heart Journal Vol. 64; no. 3; pp. 432 - 441 |
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31.05.2023
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Abstract | This study aimed to compare the clinical burden and healthcare utilization outcomes of hematologic versus solid malignancies in patients hospitalized with acute pulmonary embolism (PE). This population-based, retrospective study extracted and analyzed the discharge data from the 2016-2018 US National Inpatient Sample (NIS) of hospitalized patients with a primary diagnosis of acute PE and a subsequent diagnosis of hematologic malignancies or solid tumors. Prolonged length-of-stay (LOS) was defined as ≥75th percentile LOS of the study cohort. Unfavorable discharge was defined as discharged to nursing home or long-term facility. Univariate and multivariate regression analyses were conducted to determine associations between cancer type, presence of unstable PE, and in-hospital outcomes in acute PE patients. Patients with acute PE with solid tumors had higher rates of in-hospital deaths and unfavorable discharge than those with hematologic malignancies (6.4% versus 3.2%, P < 0.001; 14.0% versus 11.2%, P = 0.01, respectively). Acute PE patients with hematologic malignancies had a lower risk of in-hospital death (aOR: 0.43, 95% CI: 0.31-0.60), unfavorable discharge (aOR: 0.76, 95% CI: 0.63-0.92), and prolonged LOS (aOR: 0.83, 95% CI: 0.71-0.98) than those with solid tumors. Stratified analysis showed that male patients aged <60 years with hematologic malignancies had a lower risk of prolonged LOS (aOR: 0.70, 95% CI: 0.52-0.94; aOR: 0.85, 95% CI: 0.68-1.05) and unfavorable discharge (aOR: 0.40, 95% CI: 0.22-0.71; aOR: 0.65, 95% CI: 0.50-0.85) than those with solid tumors. In the comparison of the outcomes of acute PE with hematologic malignancies and solid tumors, patients with hematologic malignancy had a lower risk of in-hospital deaths, prolonged LOS, and unfavorable discharge than those with solid tumors. |
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AbstractList | This study aimed to compare the clinical burden and healthcare utilization outcomes of hematologic versus solid malignancies in patients hospitalized with acute pulmonary embolism (PE). This population-based, retrospective study extracted and analyzed the discharge data from the 2016-2018 US National Inpatient Sample (NIS) of hospitalized patients with a primary diagnosis of acute PE and a subsequent diagnosis of hematologic malignancies or solid tumors. Prolonged length-of-stay (LOS) was defined as ≥75th percentile LOS of the study cohort. Unfavorable discharge was defined as discharged to nursing home or long-term facility. Univariate and multivariate regression analyses were conducted to determine associations between cancer type, presence of unstable PE, and in-hospital outcomes in acute PE patients. Patients with acute PE with solid tumors had higher rates of in-hospital deaths and unfavorable discharge than those with hematologic malignancies (6.4% versus 3.2%, P < 0.001; 14.0% versus 11.2%, P = 0.01, respectively). Acute PE patients with hematologic malignancies had a lower risk of in-hospital death (aOR: 0.43, 95% CI: 0.31-0.60), unfavorable discharge (aOR: 0.76, 95% CI: 0.63-0.92), and prolonged LOS (aOR: 0.83, 95% CI: 0.71-0.98) than those with solid tumors. Stratified analysis showed that male patients aged <60 years with hematologic malignancies had a lower risk of prolonged LOS (aOR: 0.70, 95% CI: 0.52-0.94; aOR: 0.85, 95% CI: 0.68-1.05) and unfavorable discharge (aOR: 0.40, 95% CI: 0.22-0.71; aOR: 0.65, 95% CI: 0.50-0.85) than those with solid tumors. In the comparison of the outcomes of acute PE with hematologic malignancies and solid tumors, patients with hematologic malignancy had a lower risk of in-hospital deaths, prolonged LOS, and unfavorable discharge than those with solid tumors. |
ArticleNumber | 22-704 |
Author | Hou, Jingjing Yu, Li Wen, Siwan Qiu, Zhongmin Zheng, Ling |
Author_xml | – sequence: 1 fullname: Hou, Jingjing organization: Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine – sequence: 2 fullname: Qiu, Zhongmin organization: Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine – sequence: 3 fullname: Yu, Li organization: Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine – sequence: 4 fullname: Wen, Siwan organization: Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine – sequence: 5 fullname: Zheng, Ling organization: Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine |
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Cites_doi | 10.1056/NEJMoa1108898 10.1056/NEJMoa1408617 10.1002/rth2.12356 10.1002/stem.2845 10.1111/crj.13270 10.1002/14651858.CD008500.pub4 10.1016/S1470-2045(19)30750-8 10.7861/clinmedicine.14-5-532 10.1055/s-0041-1733856 10.1056/NEJMoa1701719 10.1016/S0140-6736(11)61904-1 10.1177/1076029620975484 10.1007/s00277-015-2566-x 10.1080/17474086.2020.1751608 10.5761/atcs.ra.19-00158 10.1056/NEJMcp1008740 10.1111/sms.13259 10.1515/cclm-2014-1010 10.1016/j.cpcardiol.2022.101157 10.1080/10428194.2020.1713321 10.1161/CIRCULATIONAHA.116.021831 10.1016/j.amjmed.2020.10.029 10.3324/haematol.2014.112896 10.1111/jth.14475 10.1093/eurheartj/ehz405 10.1182/blood-2015-03-631747 10.7861/clinmedicine.19-3-247 10.4103/jcrt.JCRT_121_18 10.21037/cdt.2017.09.01 10.1186/s12890-021-01808-9 10.1016/j.jaccao.2021.11.008 10.1016/j.ijcard.2021.01.057 10.1016/S0049-3848(01)00285-7 10.1016/j.blre.2018.06.002 10.1200/JCO.19.01461 10.1016/j.thromres.2020.12.021 10.3390/ijms22052449 10.1055/s-2007-1000660 10.1007/s12185-020-02928-4 10.5603/KP.a2018.0197 |
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References | 32. Calvillo-Argüelles O, Schoffel A, Capo-Chichi JM, et al. Cardiovascular disease among patients with AML and CHIP-related mutations. JACC CardioOncol 2022; 4: 38-49. 4. van der Hulle T, Tan M, den Exter PL, et al. Recurrence risk after anticoagulant treatment of limited duration for late, second venous thromboembolism. Haematologica 2015; 100: 188-93. 5. Howard L. Acute pulmonary embolism. Clin Med 2019; 19: 243-7. 7. Bělohlávek J, Dytrych V, Linhart A. Pulmonary embolism, part I: epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol 2013; 18: 129-38. 27. Jaiswal S, Fontanillas P, Flannick J, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Engl J Med 2014; 371: 2488-98. 11. Wang H, Xu X, Pu C, Li L. Clinical characteristics and prognosis of cancer patients with venous thromboembolism. J Cancer Res Ther 2019; 15: 344-9. 31. Soudet S, Jedraszak G, Evrard O, Marolleau JP, Garcon L, Pietri MS. Is hematopoietic clonality of indetermined potential a risk factor for pulmonary embolism? TH Open 2021; 5: e338-42. 42. Kekre N, Connors JM. Venous thromboembolism incidence in hematologic malignancies. Blood Rev 2019; 33: 2432. 9. Peng M, Yang S, Li G, et al. Solid tumor complicated with venous thromboembolism: a 10-year retrospective cross-sectional study. Clin Appl Thromb Hemost 2021; 27: 1076029620975484. 3. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020; 41: 543-603. 44. Alam AU, Karkhaneh M, Sun HL, Wu C. Survival patterns among venous thromboembolism patients with hematologic malignancies in Alberta, Canada from 2003 to 2015. Thromb Res 2021; 199: 59-66. 43. Adelborg K, Corraini P, Darvalics B, et al. Risk of thromboembolic and bleeding outcomes following hematological cancers: a Danish population-based cohort study. J Thromb Haemost 2019; 17: 1305-18. 10. Streiff MB, Holmstrom B, Angelini D, et al. Cancer-associated venous thromboembolic disease, version 2.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2021; 19: 1181-201. 41. Franchini M. Thromboembolic risk in hematological malignancies. Clin Chem Lab Med 2015; 53: 1139-47. 8. King E, Richter C, Franklyn-Miller A, et al. Whole-body biomechanical differences between limbs exist 9 months after ACL reconstruction across jump/landing tasks. Scand J Med Sci Sports 2018; 28: 2567-78. 17. Healthcare Cost and Utilization Project (HCUP). Introduction to the Nationwide Inpatient Sample (NIS) [Internet]. Rockville MD: Agency for Healthcare Research and Quality; 2019. Available at: https://www.hcup-us.ahrq.gov/db/nation/nis/NIS_Introduction_2019.jsp. Accessed April 12, 2023. 39. Schaefer JK, McBane RD, Wysokinski WE. How to choose appropriate direct oral anticoagulant for patient with nonvalvular atrial fibrillation. Ann Hematol 2016; 95: 437-49. 40. Sorigue M, Cañamero E, Siguenza P, Nomdedeu M, López-Núñez JJ. Recent developments and persisting challenges in the prevention and treatment of venous thromboembolism in patients with hematological malignancies. Leuk Lymphoma 2020; 61: 1277-91. 35. Farge D, Frere C, Connors JM, et al. 2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. Lancet Oncol 2019; 20: e566-81. 18. Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet 2012; 379: 1835-46. 19. Kucher N. Deep-vein thrombosis of the upper extremities. N Engl J Med 2011; 364: 861-9. 36. Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol 2020; 38: 496-520. 45. Kotyla PJ, Engelmann M, Giemza-Stokłosa J, Wnuk B, Islam MA. Thromboembolic adverse drug reactions in Janus kinase (JAK) inhibitors: does the inhibitor specificity play a role? Int J Mol Sci 2021; 22: 2449. 38. Ruff CT, Giugliano RP, Antman EM. Management of bleeding with non-vitamin K antagonist oral anticoagulants in the era of specific reversal agents. Circulation 2016; 134: 248-61. 30. Jaiswal S, Natarajan P, Silver AJ, et al. Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease. N Engl J Med 2017; 377: 111-21. 16. Kotecha A, Raghavan D, Yadav SK, Sule AA, Arsene C. New insights on patient-related risk factors for venous thromboembolism in patients with solid organ cancers. Int J Hematol 2020; 112: 477-86. 26. Nadir Y, Katz T, Sarig G, et al. Hemostatic balance on the surface of leukemic cells: the role of tissue factor and urokinase plasminogen activator receptor. Haematologica 2005; 90: 1549-56. 21. Mitchell LG, Sutor AH, Andrew M. Hemostasis in childhood acute lymphoblastic leukemia: coagulopathy induced by disease and treatment. Semin Thromb Hemost 1995; 21: 390-401. 34. Di Nisio M, Porreca E, Candeloro M, De Tursi M, Russi I, Rutjes AW. Primary prophylaxis for venous thromboembolism in ambulatory cancer patients receiving chemotherapy. Cochrane Database Syst Rev 2016; 12: CD008500. 13. Cui YQ, Tan XM, Liu B, et al. Analysis on risk factors of lung cancer complicated with pulmonary embolism. Clin Respir J 2021; 15: 65-73. 15. Ma SQ, Lin Y, Ying HY, Shao YJ, Li XY, Bai CM. Solid malignancies complicated with pulmonary embolism: clinical analysis of 120 patients. Chin Med J 2010; 123: 29-33. 6. Hariharan P, Giordano N, Muzikansky A, Kabrhel C. Clinical factors associated with massive pulmonary embolism and PE-related adverse clinical events. Int J Cardiol 2021; 330: 194-9. 25. Rickles FR, Falanga A. Molecular basis for the relationship between thrombosis and cancer. Thromb Res 2001; 102: V215-24. 24. Tuckuviene R, Bjerg CL, Jonsson OG, et al. Pulmonary embolism in acute lymphoblastic leukemia - an observational study of 1685 patients treated according to the NOPHO ALL2008 protocol. Res Pract Thromb Haemost 2020; 4: 866-71. 29. Busque L, Buscarlet M, Mollica L, Levine RL. Concise review: age-related clonal hematopoiesis: stem cells tempting the devil. Stem Cells 2018; 36: 1287-94. 23. Cueto-Robledo G, Cueto-Romero HD, Carrillo-Rocha DL, Roldan-Valadez E. Review of acute leukemia as a new cause of dual thrombosis (pulmonary vein thrombosis and pulmonary embolism). Curr Probl Cardiol 2022; 19: 101157. 14. Shalaby K, Kahn A, Silver ES, Kim MJ, Balakumaran K, Kim AS. Outcomes of acute pulmonary embolism in hospitalized patients with cancer. BMC Pulm Med 2022; 22: 11. 37. Crowther M, Cuker A. How can we reverse bleeding in patients on direct oral anticoagulants? Kardiol Pol 2019; 77: 3-11. 12. Stone J, Hangge P, Albadawi H, et al. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther 2017; 7: S276-84. 2. Stein PD, Matta F, Hughes MJ. Hospitalizations for high-risk pulmonary embolism. Am J Med 2021; 134: 621-5. 28. Steensma DP, Bejar R, Jaiswal S, et al. Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes. Blood 2015; 126: 9-16. 33. Agnelli G, George DJ, Kakkar AK, et al. Semuloparin for thromboprophylaxis in patients receiving chemo therapy for cancer. N Engl J Med 2012; 366: 601-9. 22. Chan TS, Hwang YY, Tse E. Risk assessment of venous thromboembolism in hematological cancer patients: a review. Expert Rev Hematol 2020; 13: 471-80. 1. Martinez Licha CR, McCurdy CM, Maldonado SM, Lee LS. Current management of acute pulmonary embolism. Ann Thorac Cardiovasc Surg 2020; 26: 65-71. 20. Mullard A, Innes H. Venous thromboembolism in malignancy. Clin Med (Lond) 2014; 14: 532-4. 22 44 23 45 24 25 27 (31) 2021; 5 28 29 30 10 32 11 33 12 34 13 35 14 36 15 37 16 38 17 39 18 19 (26) 2005; 90 1 2 3 4 5 6 7 8 9 40 41 20 42 21 43 |
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SubjectTerms | Cancer Diagnosis Embolism Healthcare Cost and Utilization Project (HCUP) Hospitalization In-hospital mortality Length of stay (LOS) Malignancy Patients Population studies Population-based Pulmonary embolisms Solid tumors Tumors |
Subtitle | Evidence from the National Inpatient Sample 2016-2018 |
Title | Disparities in the Outcomes of Acute Pulmonary Embolism in Hospitalized Patients with Hematologic Malignancy and Solid Tumor |
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