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Effect of post-filter anticoagulation on mortality in patients with cancer-associated pulmonary embolism

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Abstract

Background

Malignancy is associated with an increased risk of venous thromboembolism. Inferior vena cava filters are a viable alternative when anticoagulation is infeasible because of the risk of bleeding. Although the current guidelines recommend that all patients with a vena cava filter be treated with anticoagulation treatment when the risk of bleeding is reduced, studies concerning the role of concomitant anticoagulation after vena cava filter insertion in high-risk patients are scarce. Since many cancer patients suffer from a high risk of hemorrhagic complications, we aimed to determine the effect of post-filter anticoagulation on mortality in patients with a malignant solid tumor.

Methods

A retrospective cohort study of patients with pulmonary embolism was performed between January 2010 and May 2016. Patients with a solid tumor and vena cava filter inserted because of pulmonary embolism were included. Using Cox proportional hazards model, the prognostic effect of clinical variables was analyzed.

Results

A total of 180 patients were analyzed, with 143 patients receiving and 37 patients not receiving post-filter anticoagulation treatment. Mortality was not significantly different between the two groups. The presence of metastatic cancer and that of pancreatobiliary cancer were significant risk factors for mortality. However, post-filter anticoagulation did not show significant effect on mortality regardless of the stage of cancer.

Conclusion

In patients with cancer-associated pulmonary embolism, the effect of post-filter anticoagulation on mortality may not be critical, especially in patients with a short life expectancy.

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Acknowledgements

This study was supported by University of Ulsan College of Medicine.

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Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Jieun Kang, Yeon-Mok Oh, Sang-Do Lee & Jae Seung Lee

  2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea

    Seon Ok Kim

  3. Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Jae Seung Lee

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  1. Jieun Kang
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Correspondence to Jae Seung Lee.

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Kang, J., Kim, S.O., Oh, YM. et al. Effect of post-filter anticoagulation on mortality in patients with cancer-associated pulmonary embolism. Int J Clin Oncol 23, 1007–1013 (2018). https://doi.org/10.1007/s10147-018-1290-7

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  • DOI: https://doi.org/10.1007/s10147-018-1290-7

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