为了研究恶性肿瘤和高危肺栓塞（PE）患者的特征和预后，我们使用全国再入院数据库从2016年1月1日至2019年12月31日识别了高危PE的住院患者。主要结果是全因住院期间死亡率的差异。在28,547个高危PE患者的加权住院中，4,825例（16.9%）合并恶性肿瘤。与没有恶性肿瘤的患者相比，合并恶性肿瘤的患者除了贫血和凝血障碍外，其他共病条件的患病率较低。合并恶性肿瘤的患者使用全身溶栓、导管导向介入和手术栓塞切除的情况较少，而使用下腔静脉滤器的情况较多。调整后合并恶性肿瘤的全因住院期间死亡率较高（调整后比值比为1.91；95%置信区间为1.72至2.11；P < 0.001）。与恶性肿瘤患者相比，转移性泌尿、非结直肠消化道和肺恶性肿瘤与住院期间死亡率的发生率最高。无颅内出血（3.9% vs 3.1%；P = 0.056）和非颅内出血（21.9% vs 20.6%；P = 0.185）出血综合症在有无恶性肿瘤的住院患者之间没有差异。然而，合并恶性肿瘤的患者出现胃肠道出血的发生率较高。在这项全国性分析中，我们发现恶性肿瘤与高危PE患者住院期间死亡风险的增加独立相关。患者伴有转移性泌尿、非结直肠消化道和肺恶性肿瘤的风险最高。恶性肿瘤患者较少接受高级治疗。由Elsevier Inc.出版。

To examine the characteristics and outcomes among patients with high-risk pulmonary embolism (PE) and malignancy.The Nationwide Readmissions Database was used to identify hospitalizations with high-risk PE from January 1, 2016, to December 31, 2019. The main outcome was the difference in all-cause in-hospital mortality.Among 28,547 weighted hospitalizations with high-risk PE, 4,825 (16.9%) had malignancy. Admissions with malignancy had a lower prevalence of other comorbid conditions except for anemia and coagulopathy. The use of systemic thrombolysis, catheter-directed interventions, and surgical embolectomy was less common among admissions with malignancy, whereas the use of inferior vena cava filter was more common among those with malignancy. All-cause in-hospital mortality was higher among admissions with malignancy even after adjustment (adjusted odds ratio, 1.91; 95% CI, 1.72 to 2.11; P<.001). Metastatic genitourinary, gastrointestinal (other than colorectal), and lung malignancies were associated with the highest incidence of in-hospital mortality. The incidence of intracranial hemorrhage (3.9% vs 3.1%; P=.056) and the composite of non-intracranial hemorrhage bleeding (21.9% vs 20.6%; P=.185) was not different between admissions with and without malignancy. However, admissions with malignancy had higher incidence of gastrointestinal bleeding.In this nationwide analysis of patients admitted with high-risk PE, malignancy was independently associated with an increased risk of in-hospital mortality. The risk was highest among patients with metastatic genitourinary, gastrointestinal, and lung malignancies. Advanced therapies were less frequently used among patients with malignancy.Published by Elsevier Inc.