Elevated D-Dimer and Hypoalbuminemia as Predictors of Early Mortality in Cancer-Associated Pulmonary Embolism
Oncology (Switzerland), cilt.104, sa.5, ss.538-545, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 104 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1159/000550191
- Dergi Adı: Oncology (Switzerland)
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Sayfa Sayıları: ss.538-545
- Anahtar Kelimeler: Pulmonary embolism, Cancer, D-dimer, Albumin, Mortality, Venous thromboembolism
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Patients with active cancer have a 4- to 7-fold increased risk of venous thromboembolism (VTE) compared with the general population and are known to have higher mortality rates. Pulmonary embolism (PE), as a common manifestation of VTE, represents a significant contributor to early mortality in this population. This study aimed to evaluate clinical and biochemical factors associated with short-term mortality in hospitalized patients with cancer diagnosed with acute PE. Methods: This retrospective study included 84 patients with active malignancy and radiologically confirmed acute PE hospitalized at a tertiary care center. Demographic, clinical, and laboratory parameters were collected. The primary outcome was all-cause 1-month mortality. Univariate and multivariate logistic regression analyses were performed to identify independent predictors. Receiver operating characteristic curve analysis was used to assess the prognostic performance of D-dimer. Results: Among hospitalized patients with cancer with acute PE, the 30-day mortality rate was 26.2%. Non-survivors had higher D-dimer levels and lower serum albumin levels. D-dimer levels did not differ between patients with and without metastasis (p = 0.223). In the multivariate model adjusted for metastatic status, log-transformed D-dimer remained an independent predictor of 30-day mortality (OR: 37.19; p = 0.014), whereas albumin showed a borderline association (OR: 0.30; p = 0.052). A D-dimer cutoff of 4.186 ng/mL predicted mortality with 75% sensitivity and 70% specificity (AUC: 0.76). Combining D-dimer and albumin further increased predictive accuracy (AUC: 0.83). Conclusion: D-dimer independently predicted short-term mortality in hospitalized patients with cancer with acute PE even after adjustment for metastatic status; albumin demonstrated only a borderline association. These routinely available biomarkers may support early risk assessment but should be interpreted cautiously in the context of other clinical factors. Prospective studies are needed to validate these findings.