METHODS: Retrospective study carried out in 4 ICUs in France over a 12-year period (2009-2021). All patients with cancer and PE were included. An overlap propensity score weighting analysis was performed in the subgroup of patients treated with either unfractionated heparins (UFH) alone or low-molecular-weight heparins (LMWH) alone on 90-day mortality and major bleeding.
RESULTS: A total of 218 consecutive cancer patients admitted to ICU and presenting PE were included. The 90-day mortality rate was 42 % for the global cohort. After propensity score analysis in the subgroup of patients treated with either \"UFH alone\" (n = 80) or \"LMWH alone\" (n = 71), the 90-day mortality was similar in patients treated with UFH alone (42.6 %) vs LMWH alone (39.9 %): OR = 1.124, CI 95 % [0.571-2.214], p = 0.750. There was a significant increased toward major bleeding rates in the \"UFH alone\" group (25.5 %) as compared to \"LMWH alone\" group (11.5 %), p = 0.04.
CONCLUSIONS: In 218 patients admitted to ICU and presenting PE, the 90-day mortality rate was 42 %. Treatment with UFH alone was associated with a mortality comparable to treatment with LMWH alone but it appeared to be more prone to major bleeding.
方法:在法国的4个ICU中进行了12年(2009-2021年)的回顾性研究。包括所有患有癌症和PE的患者。在90天死亡率和大出血时,对单独使用普通肝素(UFH)或单独使用低分子量肝素(LMWH)治疗的患者亚组进行了重叠倾向评分加权分析。
结果:共纳入218例连续入住ICU并出现PE的癌症患者。全球队列的90天死亡率为42%。在“单独使用UFH”(n=80)或“单独使用LMWH”(n=71)的患者亚组的倾向评分分析后,单用UFH(42.6%)与单用LMWH(39.9%)的患者90天死亡率相似:OR=1.124,CI95%[0.571-2.214],p=0.750。与“单独使用LMWH”组(11.5%)相比,“单独使用UFH”组(25.5%)的大出血率显着增加,p=0.04。
结论:在218例进入ICU并出现PE的患者中,90天死亡率为42%.单独使用UFH的治疗与单独使用LMWH的治疗相当的死亡率相关,但似乎更容易发生大出血。