Pulmonary embolism in non-brain tumor patients after surgery—a retrospective study in China

BACKGROUND The incidence rate of pulmonary emboli (PE) is high in tumor patients; however, the morbidity and mortality associated with the development of PE after tumor surgery are unknown. We studied the clinical profiles and outcomes of patients with PE after non-brain tumor surgery. METHODS We retrospectively screened 55,967 patients who underwent non-brain tumor surgery at the Peking University Cancer Hospital from January 2008 to June 2015. Among them, 76 patients who were diagnosed with PE were enrolled in our study. Factors impacting the overall survival at 90 days were analyzed. A Kaplan-Meier curve was plotted for time to death or until day 90. Cox proportional hazard modeling was performed for univariate- and multivariate-adjusted factor analyses. RESULTS The morbidity rate was approximately 135.8 per 100,000 non-brain tumor surgery patients (possibly underestimated). When treated, seven patients had major bleeding, and 14 patients had clinically relevant non-major bleeding, which represented 9.2 and 18.4% of all the patients, respectively. The 3-month overall mortality rate was 11.8% in our study. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and platelet distribution width (PDW) were independent risk factors for the prognosis of PE after non-brain surgery (P values of 0.001 and 0.016, respectively). CONCLUSIONS Treatment of PE in non-brain tumor surgical patients remained a challenge due to the high bleeding rate. The APACHE II score and PDW were independent prognostic factors of survival in patients with PE after non-brain tumor surgery; however, the study power was limited.