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- W4229670114 abstract "Although normotensive cancer patients with acute pulmonary embolism (PE) are a heterogeneous population, most validated clinical prognostic scores classify these patients as high-risk individuals, which limits their usefulness in this setting. In this study, we aimed to identify readily available clinical predictors of overall 30-day and one-year mortality in normotensive cancer patients with PE. We performed a retrospective single-center study that included all normotensive cancer patients with PE diagnosed by multidetector computed tomography (MDCT) during emergency department stay between January 2010 and December 2011. Clinical, MDCT and laboratory variables were collected for all patients. A total of 69 patients were included. All-cause mortality was 28% and 55% at 30 days and one year of follow-up, respectively. Lower mean arterial pressure, higher lactate level and a higher Shock Index (SI) at hospital admission were associated with increased all-cause mortality at 30 days and one year of follow-up. The simplified Pulmonary Embolism Severity Index was not a predictor of short- or long-term mortality. An SI of ≥0.7 was found to be associated with lower event-free survival in both short- and long-term follow-up (hazard ratio 7.20 [95% CI, 1.66-31.21, p<0.01] and 3.51 [95% CI, 1.70-7.25, p<0.01], respectively). This is the first article reporting the value of the SI, a user-friendly and readily available clinical tool, as an independent and accurate predictor of 30-day and one-year all-cause mortality in normotensive cancer patients with symptomatic PE. Apesar de os doentes oncológicos (DO) normotensos com tromboembolia pulmonar aguda (TEP) constituírem uma população heterogénea, a maioria dos scores de prognóstico classifica estes doentes como sendo de alto risco, limitando a sua utilidade. O objetivo deste estudo foi a identificação de variáveis clínicas simples que constituíssem preditores de mortalidade aos 30 dias e a um ano em DO normotensos com TEP. Estudo retrospetivo, de centro único, que incluiu todos os DO normotensos com TEP diagnosticada por TC durante a permanência no SU, entre janeiro/2010 e dezembro/2011. Foram colhidas variáveis clínicas, radiológicas e laboratoriais. Sessenta e nove doentes foram incluídos. Uma pressão arterial média mais baixa, um valor de lactato mais alto e um valor de índice de choque (IC) mais elevado associaram-se a uma mortalidade de todas as causas mais elevada aos 30 dias e a um ano de follow-up. A taxa de mortalidade de todas as causas foi 28% e 55% aos 30 dias e a um ano de seguimento, respetivamente. O score de sPESI não foi um preditor de mortalidade a curto ou a longo prazo. Um valor de IC ≥ 0,7 associou-se a uma sobrevida mais baixa tanto a curto como a longo prazo (FC 7,20 IC 95%, 1,66 a 31,21, p < 0,01) e 3,51 (IC 95%, 1,70 a 7,25, p < 0,01), respetivamente. Este é o primeiro estudo que documenta o valor do IC como preditor independente e preciso da mortalidade aos 30 dias e a um ano de DO normotensos com TEP sintomática." @default.
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- W4229670114 date "2019-06-01" @default.
- W4229670114 modified "2023-09-26" @default.
- W4229670114 title "Keeping prognostic assessment simple: The value of clinical features in normotensive cancer patients with pulmonary embolism" @default.
- W4229670114 doi "https://doi.org/10.1016/j.repce.2018.06.012" @default.
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