Evidence map›Paper›PMID 31786713›Full record

ArticleJournal of thrombosis and thrombolysis2020

Epidemiology and diagnosis of pulmonary embolism in lung cancer patients: is there a role for age adjusted D-dimers cutoff?

I Anagnostopoulos, S Lagou, M K Spanorriga, K Tavernaraki, G Poulakou, K N Syrigos, L Thanos

Abstract read
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In one paragraph

Article in Journal of thrombosis and thrombolysis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.6field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Derivation and External Validation of a Risk Prediction Model for Pulmonary Embolism in Patients With Lung Cancer: A Large Retrospective Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
  8. Clinical Characteristics and Risk Factors of Patients with Lung Cancer Complicated with Pulmonary Embolism: A Case Control Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

I Anagnostopoulos3rd Department of Medicine, National and Kapodistrian University of Athens, Sotiria General Hospital, 152 Mesogion Avenue, Athens, 11527, Greece. iannis.anagnostopoulos@gmail.com.ORCID http://orcid.org/0000-0002-3062-360X
S Lagou3rd Department of Medicine, National and Kapodistrian University of Athens, Sotiria General Hospital, 152 Mesogion Avenue, Athens, 11527, Greece.
M K Spanorriga3rd Department of Medicine, National and Kapodistrian University of Athens, Sotiria General Hospital, 152 Mesogion Avenue, Athens, 11527, Greece.
K TavernarakiDepartment of Medical Imaging and Interventional Radiology, Sotiria General Hospital, Athens, Greece.
G Poulakou3rd Department of Medicine, National and Kapodistrian University of Athens, Sotiria General Hospital, 152 Mesogion Avenue, Athens, 11527, Greece.
K N Syrigos3rd Department of Medicine, National and Kapodistrian University of Athens, Sotiria General Hospital, 152 Mesogion Avenue, Athens, 11527, Greece.
L ThanosDepartment of Medical Imaging and Interventional Radiology, Sotiria General Hospital, Athens, Greece.
National and Kapodistrian University of Athens · GRSotiria General Hospital · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Our knowledge about the incidence of pulmonary embolism (PE) and the performance of age adjusted D-dimers (Dd) cutoff amongst patients with lung cancer (LC) and suspected PE, remains limited. We retrospectively analyzed all clinically suspected patients who underwent computed tomography pulmonary angiography (CTPA) in a tertiary hospital during a 19 month period. Cancer diagnosis was established using ICD10 code. Eligible for Dd analysis were those tested up to 24 h prior to the scan. We analyzed 2549 patients (54.6% males, median age 68.8 years, IQR 57-78), 15.8% had active LC and 5.4% other cancers (oC), while 70% were scanned in the Emergency Department (ED) and the rest during hospitalization. Overall incidence of PE was 16%. LC, but not oC, increased significantly the risk for PE (OR 1.58, 95% CI 1.21-2.06). LC patients were less likely to have bilateral (aOR 0.16, 95% CI 0.07-0.4) or central PE (aOR 0.2, 95% CI 0.09-0.48). Amongst those diagnosed with PE in the ED, LC increased all-cause inhospital mortality (aOR 6.7, 95% CI 2.64-16.95). When age adjusted instead of conventional Dd cutoff was used for ruling out PE in the ED, specificity for LC patients increased (10.16% vs 3.91%) without false negative tests (negative likelihood ratio-NLR = 0). A higher cutoff of 1.13 mg/l raised specificity to 28.9%, with only one case missed (sensitivity: 97.4%, NLR: 0.09, 95% CI 0.01-0.64). LC increases the risk for PE and adversely affects prognosis. Age adjusted and probably an even higher, "LC adjusted" Dd cutoff, could increase the specificity of the test without compromising its sensitivity.

Indexed as

AgedAged, 80 and overBiomarkersFemaleFibrin Fibrinogen Degradation ProductsGreeceHumansIncidenceLung NeoplasmsMaleMiddle AgedPulmonary EmbolismRetrospective StudiesBiomarkersFibrin Fibrinogen Degradation Productsfibrin fragment DD-dimersDiagnosisLung cancerPulmonary embolism

Identifiers

PMID31786713
OpenAlexW2990942133

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.