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The impact of incidental pulmonary cement embolism on mortality risk

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Abstract

The prognosis of pulmonary cement embolism found incidentally on chest radiography after vertebroplasty has been rarely investigated. This study was performed to elucidate the impact of incidentally found pulmonary cement embolism on all-cause mortality. Patients with pulmonary cement embolism diagnosed using chest radiography between 2008 and 2014 at one tertiary referral hospital were included. Their mortality risk was compared to that of randomly selected, age-, sex-, and year-matched patients without pulmonary cement embolism (ratio, 1:10) by using Kaplan–Meier estimates and covariate-adjusted Cox proportional regression analysis. The study included 11 patients with pulmonary cement embolism and 110 patients without pulmonary cement embolism. The patients showed no significant intergroup differences in baseline characteristics, except comorbid heart failure. During a mean follow-up duration of 1.7 ± 1.6 years, five patients (45.5%) with pulmonary cement embolism and 60 (50.0%) without pulmonary cement embolism died, mostly because of underlying malignancy. Although the patients with pulmonary cement embolism were not treated, they did not show a higher mortality risk than did those without pulmonary cement embolism (adjusted hazard ratio, 1.10; 95% confidence interval, 0.43–2.85). Subgroup analyses showed similar results. Incidentally found pulmonary cement embolism had no significant impact on all-cause mortality.

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Abbreviations

PCE:

Pulmonary cement embolism

PVP:

Percutaneous vertebroplasty

CT:

Computed tomography

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Acknowledgements

We thank Dr. Soo Jin Park for drawing the illustration of PCE mechanism.(Fig. 1)

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea

    Hye-Rin Kang & Chang-Hoon Lee

  2. Department of Radiology, Seoul National University college of Medicine, Seoul, Republic of Korea

    Tae-Hyung Kim

  3. Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea

    Chun Kee Chung

  4. Department of Radiology, Naval Pohang Hospital, Pohang, Republic of Korea

    Tae-Hyung Kim

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  1. Hye-Rin Kang
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  2. Tae-Hyung Kim
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  3. Chun Kee Chung
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  4. Chang-Hoon Lee
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Correspondence to Chang-Hoon Lee.

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Authors have no conflict of interest.

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This study was approved by the institutional review board of Seoul National University Hospital (H-1607-039-774) and was conducted in accordance with the tenets of the Declaration of Helsinki.

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Kang, HR., Kim, TH., Chung, C.K. et al. The impact of incidental pulmonary cement embolism on mortality risk. J Thromb Thrombolysis 49, 468–474 (2020). https://doi.org/10.1007/s11239-019-02027-0

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  • DOI: https://doi.org/10.1007/s11239-019-02027-0

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