{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:28:58Z","timestamp":1793647738131,"version":"4.5.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"42","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Pulmonary thromboembolism (PTE) is a severe and potentially fatal complication in patients with malignancy. Systemic inflammation plays an important role in both cancer progression and thrombogenesis. This study aimed to evaluate the association of systemic inflammatory indices with in-hospital mortality and clinical risk classification in patients with malignancy-associated PTE. This retrospective study included 75 adult patients diagnosed with both malignancy and PTE at a tertiary chest diseases center between February 2018 and June 2025. Demographic characteristics, cancer types, laboratory values at diagnosis, treatment details, and clinical outcomes were recorded. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), lymphocyte-to-CRP ratio (LCRPR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated from blood samples obtained at diagnosis. The primary outcome was in-hospital mortality, and the secondary outcome was the association between systemic inflammatory markers and ESC PTE clinical risk classification. The mean age was 69.5\u2005\u00b1\u200511.8 years, and 56% of patients were male. Lung (24%), colorectal (13.3%), and breast (9.3%) cancers were the most common malignancies. In-hospital mortality was 20%. Neutrophil count (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u2005.026), NLR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u2005.032), and lactate (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u2005.027) were significantly higher in patients who died during hospitalization. ROC analysis identified an NLR cutoff value of 4.95, with a sensitivity of 86.7% and a specificity of 51.7%. Neutrophil count and SIRI were significantly higher in the intermediate-risk group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u2005.036 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u2005.049, respectively), whereas troponin was highest in the high-risk group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u2005.001). Neutrophil count, NLR, and lactate levels were associated with in-hospital mortality in patients with malignancy-associated PTE. Neutrophil count and SIRI were also associated with ESC clinical risk classification. These findings should be considered exploratory and require validation in larger prospective studies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000051137","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:00:15Z","timestamp":1792173615000},"page":"e51137","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of systemic inflammatory markers in patients with malignancy-associated pulmonary thromboembolism"],"prefix":"10.1097","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0448-1801","authenticated-orcid":false,"given":"Esra","family":"Arslan Aksu","sequence":"first","affiliation":[{"name":"Department of Chest Diseases, Samsun University Faculty of Medicine, Samsun, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3478-5454","authenticated-orcid":false,"given":"Levent","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Samsun University Faculty of Medicine, Samsun, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7362-8710","authenticated-orcid":false,"given":"Sava\u015f","family":"Gegin","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Samsun University Faculty of Medicine, Samsun, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4678-7729","authenticated-orcid":false,"given":"Burcu","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Samsun University Faculty of Medicine, Samsun, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20261102","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"key":"R2-20261102","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1182\/blood-2007-10-116327","article-title":"Development and validation of a predictive model for chemotherapy-associated thrombosis.","volume":"111","author":"Khorana","year":"2008","journal-title":"Blood"},{"key":"R3-20261102","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1056\/NEJM199804233381701","article-title":"The risk of a diagnosis of cancer after primary deep venous thrombosis or pulmonary embolism.","volume":"338","author":"S\u00f8rensen","year":"1998","journal-title":"N Engl J Med"},{"key":"R4-20261102","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1182\/blood.2020007338","article-title":"Venous thromboembolism in cancer patients: a population-based cohort study.","volume":"137","author":"Mulder","year":"2021","journal-title":"Blood"},{"key":"R5-20261102","doi-asserted-by":"crossref","first-page":"5969","DOI":"10.2147\/JIR.S514111","article-title":"Can systemic inflammatory markers be used in pulmonary embolism risk assessment in patients with acute pulmonary thromboembolism?","volume":"18","author":"\u00d6zdemir","year":"2025","journal-title":"J Inflamm Res"},{"key":"R6-20261102","doi-asserted-by":"crossref","first-page":"dju124","DOI":"10.1093\/jnci\/dju124","article-title":"Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis.","volume":"106","author":"Templeton","year":"2014","journal-title":"J Natl Cancer Inst"},{"key":"R7-20261102","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1055\/s-0038-1673401","article-title":"Association of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio with the risk of thromboembolism and mortality in patients with cancer.","volume":"118","author":"Grilz","year":"2018","journal-title":"Thromb Haemost"},{"key":"R8-20261102","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1182\/blood-2006-10-053736","article-title":"Trousseau\u2019s syndrome: multiple definitions and multiple mechanisms.","volume":"110","author":"Varki","year":"2007","journal-title":"Blood"},{"key":"R9-20261102","doi-asserted-by":"crossref","first-page":"15593258211064744","DOI":"10.1177\/15593258211064744","article-title":"Systemic inflammation response index as a prognostic marker in cancer patients: a systematic review and meta-analysis of 38 cohorts.","volume":"19","author":"Zhou","year":"2021","journal-title":"Dose Response"},{"key":"R10-20261102","first-page":"150","article-title":"Prognostic value of systemic inflammation response index in cancer: a meta-analysis.","volume":"21","author":"Sun","year":"2021","journal-title":"Cancer Cell Int"},{"key":"R11-20261102","first-page":"313","article-title":"Assessment of prognostic value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with pulmonary embolism.","volume":"32","author":"Karata\u015f","year":"2016","journal-title":"Acta Cardiol Sin"},{"key":"R12-20261102","doi-asserted-by":"crossref","first-page":"1076029619900549","DOI":"10.1177\/1076029619900549","article-title":"Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict all-cause mortality in acute pulmonary embolism.","volume":"26","author":"Phan","year":"2020","journal-title":"Clin Appl Thromb Hemost"},{"key":"R13-20261102","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/14017431.2020.1846774","article-title":"A novel marker for predicting severity of acute pulmonary embolism: systemic immune-inflammation index.","volume":"55","author":"Gok","year":"2021","journal-title":"Scand Cardiovasc J"},{"key":"R14-20261102","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.12669\/pjms.40.6.8802","article-title":"Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of mortality in acute pulmonary embolism: a systematic review and meta-analysis.","volume":"40","author":"Tang","year":"2024","journal-title":"Pak J Med Sci"},{"key":"R15-20261102","first-page":"500","article-title":"Factors influencing mortality in cancer patients with pulmonary embolism.","volume":"10","author":"Kara\u00e7adir","year":"2024","journal-title":"Akd Med J"},{"key":"R16-20261102","doi-asserted-by":"crossref","first-page":"263","DOI":"10.22141\/2224-0586.21.3.2025.1868","article-title":"Neutrophil-to-lymphocyte ratio as a prognostic factor in patients with acute pulmonary embolism on the background of oncological disease.","volume":"21","author":"Tseluyko","year":"2025","journal-title":"Emerg Med (Ukraine)"},{"key":"R17-20261102","doi-asserted-by":"crossref","first-page":"4058","DOI":"10.3390\/jcm10184058","article-title":"The prognostic role of neutrophil-to-lymphocyte ratio in patients hospitalized with acute pulmonary embolism.","volume":"10","author":"Efros","year":"2021","journal-title":"J Clin Med"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000051137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:00:14Z","timestamp":1793646014000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000051137"}},"subtitle":["A retrospective observational study"],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":17,"journal-issue":{"issue":"42","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000051137","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2025-08-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}