Concomitant deep vein thrombosis in pulmonary embolism: a single-center study of prevalence, predictors, and in-hospital outcomes.

PURPOSE: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), remains a major cause of morbidity and mortality. Data on the clinical relevance of concomitant DVT in patients with PE are limited. This study aimed to assess the prevalence, predictors, and in-hospital outcomes associated with concomitant DVT in PE. PATIENTS AND METHODS: This retrospective single-center cohort study included 576 consecutive patients hospitalized with confirmed PE between 2013 and 2022. Concomitant DVT, in-hospital mortality, length of hospital stay (LOS), and prior PE were evaluated. Clinical characteristics, laboratory parameters, and comorbidities were analyzed. Multivariable regression models were used to identify predictors of DVT and in-hospital mortality. RESULTS: The mean age of participants was 67.3 ± 16.2 years. Concomitant DVT was present in 56.9% of patients (n=328), of whom 55.2% had asymptomatic DVT. Most patients had intermediate-risk PE (66.0%). In-hospital mortality was 6.4% (n=37). Patients with DVT had a longer LOS than those without DVT (8 vs. 7 days, p<0.003). Intermediate-risk PE was independently associated with increased odds of DVT, whereas unprovoked PE was associated with lower odds. Concomitant DVT was not an independent predictor of in-hospital mortality. Older age, chronic heart failure (CHF), and high-risk PE were independently associated with increased mortality. CONCLUSIONS: Concomitant DVT is common in patients with PE and is frequently asymptomatic. Although associated with longer hospitalization, it does not independently affect in-hospital mortality. Clinical severity remains the main determinant of short-term outcomes, and concomitant DVT appears to reflect disease presentation rather than prognosis.