PULMONARY EMBOLISM AND MALIGNANT DISEASES

Cilj: Usporediti kliničke karakteristike i ishod između pacijenata s onkološkom i bez onkološke bolesti primarno hospitaliziranih zbog plućne tromboembolije na Zavodu za kardiologiju KBC-a Rijeka tijekom 2018. godine. Materijali i metode: Analiza je retrospektivna. Istraživanjem je obuhvaćeno 124 pacijenta, od čega su 33 bila onkološka i 91 neonkološki. Izvršena je usporedba između dvaju skupina s obzirom na duljinu hospitalizacije, demografske podatke, podležeće komorbiditete u anamnezi, simptome po primitku ili dijagnosticiranju embolije i nalaze cjelokupnog dijagnostičkog protokola. Algoritam je uključio laboratorijske nalaze, EKG i slikovne metode, odnosno radiološki prikaz grudnih organa, MSCT plućnu angiografiju, ehokardiografiju i color Doppler vena. Također se usporedila razlika u odabiru terapije između skupina, te analizirao rizik od rane smrtnosti i intrahospitalni ishod. Prikazana je učestalost pojedinih maligniteta u istraživanju. Rezultati: Najučestaliji tumori bili su gastrointestinalni, karcinom dojke, karcinom pluća, tumor mozga, limfom i tumor pankreasa. Anemija je jedina podležeća dijagnoza koja se sa statističkom značajnošću češće javljala kod onkološke skupine, što je potkrijepljeno i razlikom u nalazima laboratorija. Dispneja i bol u grudima su najzastupljeniji simptomi. Onkološki bolesnici su se značajno učestalije prezentirali bez simptoma. Trombociti su bili značajno viši u onkološkoj skupini. Neonkološki bolesnici pri otpustu dobivaju peroralne antikoagulanse, a onkološka skupina češće LMWH. Zaključak: PTE je česta u onkoloških bolesnika, najučestalija u malignim bolestima crijeva. Često se javlja bez simptoma PTE te se otkriva incidentalno slikovnim pretragama. Praćena je anemijom, trombocitozom i povišenim RDW. Češće se liječi LMWH u odnosu na peroralnu antikoagulantnu terapiju.Aims: To evaluate clinical features and outcome among the oncologic and non-oncologic group of patients primarily hospitalized for pulmonary thromboembolism at the Department of Cardiology, Clinical hospital centre of Rijeka, during the year of 2018. Methods: A retrospective study was performed on 124 patients, which were categorized into 33 oncological and 91 non-oncological patients. The difference according the hospital stay, demographic factors, underlying comorbidities, clinical presentation and diagnostic test results were analyzed between two subsets. Diagnostic approach included laboratory findings, ECG and imaging tests, i.e. chest X-ray, CTPA, echocardiography and Doppler ultrasonography. Therapeutic options, early mortality risk and intrahospital survival rates were analyzed. Research also demonstrated the commonest tumor types that were related to pulmonary embolism. Results: The most frequent tumors were gastrointestinal, breast, lung, and pancreatic cancer, brain tumor and lymphoma. Anemia was the only comorbidity that presented more often in oncologic group, which was supported with alteration in lab findings. The most common symptoms were dyspnoea and chest pain. PE was reportedly asymptomatic in oncologic patients. High platelet count was detected in oncologic group. Oral anticoagulation was therapeutic option for non-oncologic patients, while LMWH was more often administred to patients with malignant disease. Conclusion: PE is common diagnosis in oncologic population, and the most frequent with intestinal cancer. It is often presented without symptoms and incidentally diagnosed by imaging tests. It is followed by anemia, thrombocytosis and elevated RDW. Oncologic patients are treated with LMWH more often than with oral anticoagulants