Risk factors for pulmonary embolism in malignant tumors patients with lower limb deep vein thrombosis: a retrospective study.

Objective: To identify the risk factors associated with pulmonary embolism (PE) in malignant tumor patients with lower limb deep vein thrombosis (LLDVT).

Methods: We retrospectively analyzed the clinical data of 45 patients with PE (observation group) and 255 patients without PE (control group) admitted to The Second Affiliated Hospital of Shandong First Medical University between June 2020 and January 2025. Various clinical parameters, including LLDVT density ratio, D-dimer, homocysteine (Hcy) and cardiac troponin I (cTNI), were compared between the two groups. Logistic regression analysis was performed to identify independent risk factors for PE.

Results: The observation group had significantly higher values for LLDVT density ratio (P<0.001), D-dimer (P=0.004), Hcy (P<0.001), cTNI (P<0.001), and Wells scores (P<0.001) compared to the control group. Logistic regression revealed that LLDVT density ratio, Hcy, cTNI, and Wells scores were independent risk factors for PE in these patients. Pearson correlation analysis showed significant positive associations between the LLDVT density ratio (r=0.822, P<0.001), Hcy (r=0.899, P<0.001), cTNI (r=0.890, P<0.001), and Wells scores. ROC curve analysis indicated that the combined model (LLDVT density ratio, Hcy, and cTNI) had a higher AUC (0.852) than individual markers.

Conclusion: LLDVT density ratio, Hcy, and cTNI are independent predictors of PE in malignant tumor patients with LLDVT. These markers are closely associated with PE severity, which could assist in optimizing clinical management for these patients.