Do Patients with Acute Pulmonary Embolism and an Intermediate or High PESI (Pulmonary Embolism Severity Index) Score Associated with Active Cancer Have Higher Risk of an Unfavorable Progression Versus Those Without Cancer?

pp. 101-107

Abstract

Background: The Pulmonary Embolism Severity Index (PESI) is used to categorize the risk of death in acute pulmonary embolism (PE). By definition, cancer patients will always have a high simplified PESI score and will be considered at high risk. There is limited information regarding whether patients with an intermediate or high PESI score (≥86 points) and cancer are at greater risk of an unfavorable progression versus those without cancer.

Objectives: To determine whether the presence of active cancer in patients with a PESI score ≥86 points is associated with an unfavorable progression versus those without cancer. 

Methods: A retrospective analysis in patients with PE and a PESI score ≥86, between 2008 and 2022. The occurrence of inhospital mortality (IHM) the use of vasopressor drugs (VDs), and the need for mechanical ventilatory support (MVS) were evaluated.
Results: 209 patients were analyzed. The population with cancer was younger than patients without cancer (65 vs 70 years; p=0.006), showed high simplified PESI values more frequently (100% vs 84%; p<0.001), had lower MVS requirement (9% vs 34%; p=0.005), and used fewer VDs (11% vs 23%; p=0.019). However, no difference was observed in IHM rates (12.7% vs 8%; p=NS).

Conclusions: Patients with PE and a PESI score ≥86 who have cancer did not show higher IHM and also had lower MVS and VDs requirement. Therefore, in the studied population, patients with PE and cancer had no greater risk of having an unfavorable progression.

How to cite this article:

Bonorino JM, Bilbao JA, Tórres NA, Iwanowski M, Spaini EM, Gallegos AF, y cols.  Do Patients with Acute Pulmonary Embolism and an Intermediate or High PESI (Pulmonary Embolism Severity Index) Score Associated with Active Cancer Have Higher Risk of an Unfavorable Progression Versus Those Without Cancer? Rev Argent Cardiol 2024;92:101-107.  http://dx.doi.org/10.7775/rac.v92.i2.20744