Pulmonary Embolism, Myocardial Infarction, and Ischemic Stroke in Lung Cancer Patients: Results from a Longitudinal Study

Lung cancer related hypercoagulability could increase the risk of ischemic stroke. Routine coagulation tests may have limited capacity in evaluating hypercoagulability. The aim of this study was to investigate the ability of thromboelastography (TEG) in the identification of hypercoagulability in patients with lung cancer and cryptogenic ischemic stroke (LCIS). Between January 2016 and December 2018, whole citrated blood from LCIS patients (n = 35) and age- and gender-matched lung cancer patients and healthy volunteers were used for TEG and routine coagulation tests. The coagulation indicator and clinical data were compared among the 3 groups. There were 27/35 (77.14%) on TEG and 18/35 (51.43%) on routine coagulation tests of LCIS patients who had evidence of hypercoagulability. The detection rate of hypercoagulability by TEG in LCIS patients was higher than routine coagulation tests ( P = 0.018). Comparing with lung cancer patients and healthy controls, LCIS patients have a significantly higher maximum amplitude (MA), fibrinogen, and D-dimer. Multivariate analysis showed that D-dimer and MA were significantly associated with ischemic stroke in lung cancer patients. ROC curve showed that the area under the curve of TEG (0.790 ± 0.048, 95% CI: 0.697-0.864) was significantly higher than routine coagulation tests (0.673 ± 0.059, 95% CI: 0.572-0.763) ( P = 0.04) in identifying hypercoagulability in LCIS patients. Therefore, TEG could identify hypercoagulability in LCIS patients and healthy controls. Identification of hypercoagulability in lung cancer patients by TEG may be helpful to prevent the occurrence of LCIS.

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Psychological Characteristics of Lung Cancer Patients During the 2019 Novel Coronavirus Outbreak: A Cross-Sectional and Longitudinal Study Based on a Propensity Score-Matched Population

10.21203/rs.3.rs-932424/v1 ◽

2021 ◽

Author(s):

Kai Qian ◽

Yi Deng ◽

Yun Chen ◽

Hao Peng ◽

Li-Hong Jiang

Keyword(s):

Lung Cancer ◽

Longitudinal Study ◽

Propensity Score ◽

Cancer Patients ◽

Cross Sectional Study ◽

Education Level ◽

Psychological Characteristics ◽

Sectional Study ◽

Cross Sectional ◽

Lung Cancer Patients

Abstract Objective: This study sought to reveale the psychological characteristics of lung cancer patients at different time points of the COVID-19 epidemic. Methods: This cross-sectional study used data from two different regional medical centers. 128 pairs of lung cancer (LC) patients and non-lung cancer subjects (NLC) were selected through propensity score matching (PSM) analysis. For the longitudinal study, the anxiety and distress state before and during the COVID-19 pandemic were surveyed through a dedicated questionnaire. Results: A total of 135 LC patients and 165 healthy individuals were included in this cross-sectional study. After PSM analysis, 128 pairs of LC patients and NLC were matched and compared in this analysis. During the uptrend period of COVID-19 epidemic, there were significant differences in anxiety between LC patients and NLC (P=0.005). For LC patients, the proportions of severe distress differed significantly between the uptrend and the decline period (22.05% vs 11.90%, P=0.032). In two-way repeated ANOVA analysis, no significant main effect for group or group × condition interaction effect has been founded. The distress of LC patients is mainly manifested as worry. Logistic regression showed that gender (OR=41.48, 95% CI: 9.74-17.97), age (OR=0.20, 95% CI: 0.08-0.50), and education level (OR=4.82, 95% CI: 1.98-11.69) were correlated with “worry” and contributed significantly to the model. Conclusions: This study revealed that lung cancer patients had significant anxiety and distress during the uptrend period of the COVID-19 epidemic. The distress states of LC patients mainly manifested as worry, which was associated with age, gender, and education level.

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