Predictors of mid-term prognosis and adverse factors in acute pulmonaryembolism

• Published in: Therapeutic advances in respiratory disease Vol. 11; no. 8; pp. 293 - 300
• Main Authors: Liu, Xin, Chang, Suchi, Fu Cuiping, Huo Zhirong, Zhou, Jing, Liu, Chengying, Li Shanqun, Sun, Aijun
• Format: Journal Article
• Language: English
• Published: Thousand Oaks SAGE PUBLICATIONS, INC 01.08.2017
• Subjects: Cancer; Medical prognosis; Pulmonary embolisms; Regression analysis
• DOI: 10.1177/1753465817717168
• ISSN: 1753-4658

Background: To explore the differences in short and middle term adverse factors of pulmonaryembolism (PE) outcome. Methods: This was a single-center retrospective study of inpatients admitted from ZhongshanHospital, Fudan University, with first-time PE. Clinical data were collected frompatients with objectively confirmed PE, and a 2-year follow up was conducted. Results: The sample contained 310 patients with PE, ranging in age from 18 to 86 years old (mean63.28 ± 15.30) and including 165 men (53.2%) and 145 women (46.8%). Successful treatmentwas achieved in 285 cases (91.9%) and unsuccessful treatment turned out in 25 cases(8.1%). Logistical regression analysis showed that massive PE [odds ratio (OR) = 23.625,95% confidence interval (CI) 6.248–89.333], hypoxemia (OR = 11.915, 95% CI1.900–74.727), leukocytosis (OR = 9.120, 95% CI 2.227–37.349) and active cancer (OR =6.142, 95% CI 1.233–30.587) were associated with a poor prognosis for acute PE in theshort term (in hospital). Seventy-seven PE cases with complete electronic records werefinally included in the follow up. Cox regression analysis showed that elevatedpulmonary artery systolic pressure (PASP, ⩾50 mmHg) (HR = 9.240, 95% CI, 2.307–37.013)and active cancer with PE (HR = 3.700, 95% CI, 1.010–13.562) were associated with anincreased risk of mid-term mortality after a follow-up period of 2 years. Conclusions: Massive PE, hypoxemia, leukocytosis and active cancer may contribute to a poorprognosis for patients with acute PE in hospital. Elevated PASP and active cancer maynegatively impact survival time and increase the risk of death for patients with acutePE after 2-year follow up. Short-term adverse factors of acute PE are not exactly thesame as the mid-term risk factors of acute PE.