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Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism

机译:急性肺栓塞中期预后及不良因素的预测

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To explore the differences in short and middle term adverse factors of pulmonary embolism (PE) outcome. This was a single-center retrospective study of inpatients admitted from Zhongshan Hospital, Fudan University, with first-time PE. Clinical data were collected from patients with objectively confirmed PE, and a 2-year follow up was conducted. The sample contained 310 patients with PE, ranging in age from 18 to 86 years old (mean 63.28 ± 15.30) and including 165 men (53.2%) and 145 women (46.8%). Successful treatment was 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% CI 1.900–74.727), 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 the short term (in hospital). Seventy-seven PE cases with complete electronic records were finally included in the follow up. Cox regression analysis showed that elevated pulmonary 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 an increased risk of mid-term mortality after a follow-up period of 2 years. Massive PE, hypoxemia, leukocytosis and active cancer may contribute to a poor prognosis for patients with acute PE in hospital. Elevated PASP and active cancer may negatively impact survival time and increase the risk of death for patients with acute PE after 2-year follow up. Short-term adverse factors of acute PE are not exactly the same as the mid-term risk factors of acute PE.
机译:探讨短期和中期不利因素的肺栓塞(PE)的差异。这是对复旦大学附属中山医院住院患者进行首次体育锻炼的单中心回顾性研究。从客观确诊为PE的患者中收集临床数据,并进行了2年的随访。样本包括310名PE患者,年龄在18至86岁之间(平均63.28±15.30),包括165名男性(53.2%)和145名女性(46.8%)。成功治疗285例(91.9%),未成功治疗25例(8.1%)。 Logistic回归分析显示大量PE [优势比(OR)= 23.625,95%置信区间(CI)6.248–89.333],低氧血症(OR = 11.915、95%CI 1.900–74.727),白细胞增多症(OR = 9.120,95% CI 2.227–37.349)和活动性癌症(OR = 6.142,95%CI 1.233–30.587)在短期内(医院)与急性PE预后不良相关。最终纳入随访的有完整电子记录的77例PE病例。 Cox回归分析表明,肺动脉收缩压升高(PASP,?50 mmHg)(HR = 9.240,95%CI,2.307–37.013)与PE活跃的癌症(HR = 3.700,95%CI,1.010–13.562)相关随访2年后中期死亡率增加的风险。大量PE,低氧血症,白细胞增多和活动性癌症可能会导致急性PE住院患者的不良预后。 PASP升高和活动性癌症可能对急性PE患者进行2年的随访,从而影响其生存时间并增加其死亡风险。急性PE的短期不良因素与急性PE的中期危险因素并不完全相同。

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