TY - JOUR
T1 - Pulmonary embolism at autopsy in cancer patients
AU - Gimbel, Inge A.
AU - Mulder, Frits I.
AU - Bosch, Floris T. M.
AU - Freund, Jan Erik
AU - Guman, Noori
AU - van Es, Nick
AU - Kamphuisen, Pieter W.
AU - Büller, Harry R.
AU - Middeldorp, Saskia
N1 - Funding Information: Dr. van Es has received advisory board fees from Bayer, Daiichi Sankyo, and LEO Pharma, which were transferred to his institution. Dr. Kamphuisen received research funding from Daiichi Sankyo. Dr. Middeldorp received grants and fees paid to her institution from GlaxoSmithKline, BMS/Pfizer, Aspen, Daiichi Sankyo, Bayer, Boehringer Ingelheim, Sanofi, and Portola. The remaining authors declare no conflict of interest. Publisher Copyright: © 2021 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis
PY - 2021/5
Y1 - 2021/5
N2 - Background: Pulmonary embolism (PE) is a potentially fatal disease, but data on the incidence of fatal PE in cancer patients are scant. Objective: We sought to estimate the proportion of cancer patients with PE at autopsy. Methods: For this retrospective cohort study, all autopsy reports of cancer patients were retrieved from PALGA: Dutch Pathology Registry and used for data extraction. The primary outcome was PE at time of autopsy, defined as any clot obstructing a pulmonary artery. The secondary outcome was venous thromboembolism, defined as the composite of thrombotic PE, deep vein thrombosis, splanchnic vein thrombosis, or internal jugular vein thrombosis. Results: A total of 9571 cancer patients were included. In 1191 (12.4%; 95% confidence interval [CI], 11.8-13.1) patients, one or more PE events were observed at autopsy, of whom 1074 (90.2%) had a thrombotic embolism, 168 (14.1%) a tumor embolism, 9 (0.8%) a septic embolism, 7 (0.6%) a fat tissue embolism, and 3 (0.3%) a bone marrow embolism. Among patients with PE for whom the cause of death was specified in the autopsy report, death was considered PE-related in 642 patients (66.7%), which was 6.7% of the total study population. Venous thromboembolism was observed in 1223 (12.8%; 95% CI, 12.1-13.5) patients. Conclusion: The proportion of PE in cancer patients at autopsy is substantial. Although the study population is not representative for the total cancer population, it suggests that PE is an important disease complication in cancer patients.
AB - Background: Pulmonary embolism (PE) is a potentially fatal disease, but data on the incidence of fatal PE in cancer patients are scant. Objective: We sought to estimate the proportion of cancer patients with PE at autopsy. Methods: For this retrospective cohort study, all autopsy reports of cancer patients were retrieved from PALGA: Dutch Pathology Registry and used for data extraction. The primary outcome was PE at time of autopsy, defined as any clot obstructing a pulmonary artery. The secondary outcome was venous thromboembolism, defined as the composite of thrombotic PE, deep vein thrombosis, splanchnic vein thrombosis, or internal jugular vein thrombosis. Results: A total of 9571 cancer patients were included. In 1191 (12.4%; 95% confidence interval [CI], 11.8-13.1) patients, one or more PE events were observed at autopsy, of whom 1074 (90.2%) had a thrombotic embolism, 168 (14.1%) a tumor embolism, 9 (0.8%) a septic embolism, 7 (0.6%) a fat tissue embolism, and 3 (0.3%) a bone marrow embolism. Among patients with PE for whom the cause of death was specified in the autopsy report, death was considered PE-related in 642 patients (66.7%), which was 6.7% of the total study population. Venous thromboembolism was observed in 1223 (12.8%; 95% CI, 12.1-13.5) patients. Conclusion: The proportion of PE in cancer patients at autopsy is substantial. Although the study population is not representative for the total cancer population, it suggests that PE is an important disease complication in cancer patients.
KW - autopsy
KW - neoplasms
KW - pulmonary embolism
KW - thrombosis
KW - venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85103156994&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jth.15250
DO - https://doi.org/10.1111/jth.15250
M3 - Article
C2 - 33501757
SN - 1538-7933
VL - 19
SP - 1228
EP - 1235
JO - Journal of thrombosis and haemostasis
JF - Journal of thrombosis and haemostasis
IS - 5
ER -