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Comparison of Clinical and Imaging Characteristics and Outcomes between Provoked and Unprovoked Acute Pulmonary Embolism in Koreans

机译:朝鲜族诱发性和非诱发性急性肺栓塞的临床和影像学特征及结果比较

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摘要

This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 ± 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 ± 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
机译:这项研究的目的是比较韩国人的无自发性肺栓塞(PE),诱发性PE具有可逆危险因素(provoked-rRF)和诱发性PE具有不可逆危险因素(prooked-iRF)的临床和影像学参数。包括300例被诊断为急性PE的连续患者(平均年龄,63.6±15.0岁;男性为42.8%)。将患者分为3组。无缘无故的PE,挑衅的rRF和挑衅的iRF;分别为43.7%,14.7%和41.7%。我们对患者进行了25.4±33.7个月的随访。复合终点为全因死亡率和复发性PE。激惹的iRF组的全因死亡率,PE和复发性PE的死亡率均明显高于未激惹的rRF组和激惹的rRF组(分别为P <0.001,P <0.001和P = 0.034)。未经诱发的组的复合终点的预后因素是肌酐高(> 1.2 mg / dL; P <0.001;危险比[HR],4.735; 95%置信区间[CI],1.845-12.152),C反应蛋白(CRP) ;> 5 mg / L; P = 0.002; HR,5.308; 95%CI,1.824-15.447)和计算机断层扫描(CT)阻塞指数(P = 0.034; HR,1.090; 95%CI,1.006-1.181)。总之,激惹的iRF的预后比非激惹的PE和激惹的rRF差。肾功能不全,高CRP和CT阻塞指数是无​​缘无故PE患者的不良预后因素。

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