Malignant Tumor Is the Greatest Risk Factor for Pulmonary Embolism in Hospitalized Patients: A Single-Center Study

Abstract BackgroundThis study aimed to investigate the background of patients who presented with pulmonary embolism (PE) on contrast-enhanced chest computed tomography (CT) and to explore the risk factors for PE.MethodsThis study included a review of the medical records of all 50,621 patients who were admitted to one community hospital between January 1, 2013 and December 31, 2017. Data on sex, age, risk factors related to blood flow stagnation (obesity, long-term bed rest, cardiopulmonary disease, cast fixation, long-term sitting), risk factors related to vascular endothelial disorder (surgery, trauma/fracture, central venous catheterization, catheter tests/treatments, vasculitis, antiphospholipid antibody syndrome, history of venous thromboembolism (VTE)), and risk factors related to hypercoagulability (malignant tumor, use of oral contraceptives/low-dose estrogen progestin/steroids, infection, inflammatory enteric disease, polycythemia, protein C or protein S deficiency, dehydration) were evaluated.ResultsOf all inpatients, 185 (0.37%) were diagnosed with PE after contrast-enhanced chest CT examination. The rate of discovering PE was significantly greater in women (0.48%, 93/19,409) than men (0.29%, 92/31,212) (P=0.0008). Of the 185 patients with PE, 173 (94%) had some type of risk factor. For both men and women, the most frequent risk factor was a malignant tumor, followed by infection and obesity for men and long-term bed rest and obesity for women. The most common malignant tumor was lung cancer. Of the 12 patients whose clear PE-inducing factor could not be identified, but there is possible involvement of antipsychotic agent.ConclusionsThe risk factors for PE were identified in this single-center, retrospective study.