Clinical characteristics and prognosis of cancer patients with pulmonary embolism
Bulgarian Medical Journal, 2025, 19(2), 60-65.
G. Gospodinova1, L. Demirevska1,2, I. Daskalov1
1 Cardiology Clinic, Department of Cardiology, Intensive Care and Internal Medicine, Military Medical Academy – Sofia
2 South-West University „Neofit Rilski“ – Blagoevgrad
Abstract.
Objective: The incidence of pulmonary embolism (PE) is higher among cancer patients. The purpose of this study is to describe the clinical characteristics and short-term outcomes in patients with PE and active cancer.
Materials and Methods: This is a retrospective, single-center cohort study conducted at the Military Medical Academy – Sofia, including patients with active cancer who were hospitalized between January 2022 and September 2024. A total of 76 patients were enrolled (65.8% male, mean age 65.40 ± 10.9 years), of whom 45 were diagnosed with PE. All patients underwent computed tomographic pulmonary angiography. A comparative analysis was performed between the groups with and without PE.
Results: Patients with cancer-associated PE exhibited a higher prevalence of arterial hypertension (68.9% vs. 61.3%, p = 0.045) and a history of prior venous thromboembolism (20.0% vs. 3.2%, p < 0.001) compared to the non-PE group. These patients also demonstrated impaired renal function, with 51.1% having an estimated glomerular filtration rate (eGFR) < 60 ml/min, compared to 35.5% in the non-PE group. In addition, metastatic disease was significantly more prevalent in the PE group (53.3% vs. 25.8%, p < 0.001). In-hospital mortality was significantly higher in patients with PE compared to those without PE (17.8% vs. 3.2%, p < 0.001), as was 30-day mortality (12.9% vs. 4.4%, p < 0.001).
Conclusion: Patients who suffer from cancer with PE have a higher prevalence of metastatic disease and significantly increased in-hospital and 30-day mortality rates.
Key words: pulmonary embolism, carcinoma, mortality, risk factors
Address for correspondence: Gabriela Gospodinova, MD, e-mail: