Gallus Alexander
Department of Haematology and Genetic Pathology, Flinders University School of Medicine, Flinders Medical Centre, Adelaide, Australia.
Nat Clin Pract Cardiovasc Med. 2008 Oct;5(10):604-5. doi: 10.1038/ncpcardio1308. Epub 2008 Aug 5.
In a registry of 15,520 patients treated for symptomatic deep vein thrombosis or pulmonary embolism (PE), the 90-day mortality was 8.65% and death was attributed to PE in 1.68% of patients (19.4% of all deaths). Multivariate analysis defined five simple predictors of death from PE during the first 3 months after presentation. The odds ratio for fatal PE was raised to 5.4 by initially nonmassive symptomatic PE (compared with deep vein thrombosis and no symptoms of PE), to 17.5 by initially massive PE (systolic blood pressure below 90 mmHg), 4.9 by immobility as a result of neurological disease, 2.5 by age over 75 years, and 2.0 by the presence of cancer. Of all the deaths from PE, 75% occurred within 12 days of presentation and 50% occurred within 5 days. These results reinforce previous observations that also linked symptomatic PE, massive PE, old age, and cancer to a raised likelihood of death from PE despite appropriate therapy.
在一项针对15520例有症状的深静脉血栓形成或肺栓塞（PE）患者的登记研究中，90天死亡率为8.65%，1.68%的患者死亡归因于PE（占所有死亡病例的19.4%）。多因素分析确定了发病后前3个月内PE死亡的五个简单预测因素。初始非大面积有症状PE（与深静脉血栓形成且无PE症状相比）使致命性PE的比值比升至5.4，初始大面积PE（收缩压低于90 mmHg）使其升至17.5，因神经系统疾病导致的活动不能使其升至4.9，年龄超过75岁使其升至2.5，存在癌症使其升至2.0。在所有PE死亡病例中，75%发生在发病后12天内，50%发生在5天内。这些结果强化了先前的观察结果，即尽管进行了适当治疗，但有症状的PE、大面积PE、老年和癌症也与PE死亡可能性增加有关。
