Back to Journals » Patient Preference and Adherence » Volume 7

The application of clinical variables and models to predict pulmonary embolism in cancer patients: a comprehensive single cancer center experience

Authors Mansour A, Ismael Y, Abunasser M, Hammode E, Turfa R, Abdel-Razeq H

Received 7 April 2013

Accepted for publication 15 May 2013

Published 23 October 2013 Volume 2013:7 Pages 1111—1116


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Asem Mansour,1 Yousef Ismael,2 Mahmoud Abunasser,2 Emad Hammode,2 Rim Turfa,2 Hikmat Abdel-Razeq2

1Department of Radiology, King Hussein Cancer Center, Amman, Jordan; 2Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan

Introduction: Prompt diagnosis and treatment of pulmonary embolism (PE) can help reduce its associated morbidity and mortality. Computed tomography chest angiography (CTA) scanning is the most widely used diagnostic modality. In noncancer patients, only 10% of such studies are positive for PE. Clinical variables, individual or in combination, that can predict test positivity are highly needed.
Materials and methods: All CTAs requested to confirm or exclude a diagnosis of PE in a single comprehensive cancer center were reviewed. In addition to the Wells score, other clinical variables known to increase the risk of PE were analyzed.
Results: A total of 778 adult cancer patients were treated at King Hussein Cancer Center (Amman, Jordan) and were included in this study; the majority of patients (64.2%) had stage 4 disease. Overall, 129 (16.6%) patients had positive scans for PE, while alternative diagnoses were made in 308 (39.6%) patients. Cancer stage and anticancer treatment had no impact on positive PE rates. However, Wells criteria classified patients into three risk groups with PE rates of 10.2%, 16.1%, and 62.5% among the patients with low, moderate, and high risk, respectively (P < 0.0001). Duration of cancer diagnosis (<12 months versus >12 months) had a significant impact on positive PE studies (22.0% versus 12.4%, respectively, P = 0.007).
Conclusion: The rate of positive PE studies in cancer patients is higher than previously reported in noncancer patients. Positivity for PE was higher during the first 12 months of cancer diagnosis and in those with high probability score according to the Wells criteria. Factors like primary tumor stage and anticancer therapy had no significant impact on PE-positive studies.

Keywords: pulmonary embolism, thromboembolism, cancer, CT angiography

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Intravenous iron monotherapy for the treatment of non-iron-deficiency anemia in cancer patients undergoing chemotherapy: a pilot study

Abdel-Razeq H, Abbasi S, Saadi I, Jaber R , Abdulelah H

Drug Design, Development and Therapy 2013, 7:939-944

Published Date: 30 August 2013

Current neoadjuvant treatment options for HER2 positive breast cancer

Abdel-Razeq H, Marei L

Biologics: Targets and Therapy 2011, 5:87-94

Published Date: 9 August 2011

Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

Hikmat N Abdel-Razeq, Asem H Mansour, Yousef M Ismael

Vascular Health and Risk Management 2011, 7:153-158

Published Date: 15 March 2011

Inferior vena cava filters in cancer patients: to filter or not to filter

Hikmat Abdel-Razeq, Asem Mansour, Yousef Ismael, et al

Therapeutics and Clinical Risk Management 2011, 7:99-102

Published Date: 10 March 2011

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010