Characteristics and risk factors for advanced lung cancer with pulmonary embolism: A cross-sectional, case-control study

Clin Respir J. 2023 Oct;17(10):1048-1057. doi: 10.1111/crj.13692. Epub 2023 Sep 7.

Abstract

Objectives: Pulmonary embolism (PE) is a life-threatening complication that can occur in patients with lung cancer. In this study, we aimed to identify risk factors and examine the clinical characteristics of advanced lung cancer patients with PE.

Methods: We conducted a retrospective review of patients admitted to our two hospitals between January 2020 and June 2022. The case group consisted of patients with lung cancer and PE, and a closely matched control group was included to identify risk factors. Statistical analysis was conducted using R language.

Results: A total of 4957 patients were reviewed, and 162 patients (comprising 54 cases and 108 controls) were included in this study. The prevalence of lung cancer with PE in the study population was 1.08%. The majority of patients were male, and the most common histological subtype was adenocarcinoma (67%), followed by squamous cell carcinoma, small cell carcinoma, and poorly differentiated non-small cell lung cancer. The majority of patients had a high performance status (PS) score, with 50% experiencing respiratory failure (mainly hypoxia) and 33% with deep vein thrombosis (DVT). Forty-eight percent of patients were diagnosed with concurrent PE. Further analysis showed that PE was an independent predictor of poor survival, and a PS score of >1 was an independent risk factor for PE in patients with lung cancer.

Conclusion: Our study provides valuable insights into the epidemiology and prognosis of PE in lung cancer patients and suggests that a poor ECOG PS, which has not been previously reported, is an independent risk factor for PE.

Keywords: characteristic; lung cancer; prevalence; risk factors; survival.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / complications
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / epidemiology
  • Male
  • Pulmonary Embolism* / diagnosis
  • Retrospective Studies
  • Risk Factors