Outpatient management of incidental pulmonary embolism in cancer patient
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Incidentally discovered pulmonary embolism is a prevalent clinical problem for cancer patients and contributes significantly to the burden of cancer-associated thrombosis. The aim of this study was to explore if outpatient management of incidental pulmonary embolism (iPE) in cancer patients is effective and can be conducted safely.
We performed a prospective observational cohort study in a single Spanish tertiary hospital. Patients diagnosed with iPE and active cancer were enrolled. Between May 2016 and May 2017, 25 consecutive patients were included in the study.
All patients were assessed in the emergency room (ER) and started treatment with low-molecular weight heparins (LMWH) being discharged in the following 24 h. Congestive heart failure and right ventricular dysfunction were ruled out, and none of them presented massive PE, active bleeding or any disease-related reason that required hospitalization. The 90-day follow-up visit showed no venous thromboembolism (VTE) recurrence and the major bleeding rate was 4%. Mortality rate at 30 and 90 days was 0%.
Outpatient management for iPE in cancer patients appears to be feasible and safe in selected cancer patients.
KeywordsIncidental pulmonary embolism Venous thromboembolism Cancer Outpatient treatment Anticoagulant treatment Low-molecular weight heparins
This study had no funding.
Compliance with ethical standards
Conflict of interest
Andrés J. Muñoz Martin: Dr. Muñoz has received speakers’ honoraria or honoraria for participation in Advisory Boards from Sanofi, Celgene, Leo Pharma, Daiichi Sankyo, Pzifer-BMS, Rovi, Celgene, Shire, Astra-Zeneca and Medscape and research grants from Sanofi and Leo Pharma. Magdalena Carmen Ruiz Zamorano, María Carmen Viñuela Benéitez, Laura Ortega Morán and Ángela García Pérez declare that they have no conflict of interest. Dr. Miguel Martín Jiménez: Dr. Martin has received speakers’ honoraria or honoraria for participation in Advisory Boards from AstraZeneca, Novartis, Roche-Genentech, Pfizer Glaxo, Pharmamar, Taiho Oncology and Lilly, and research grants from Novartis and Roche.
Informed consent was obtained from all individual participants included in the study.
The study was approved by the Ethics Committee of Hospital General Universitario Gregorio Marañón, Madrid, Spain. The study has been approved by the appropriate institutional and/or national research ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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