Sharma Mirella, Degoricija Vesna, Legac Ante, Gradiser Marina, Vucicević Zeljko
Department of Medicine, University Hospital "Sestre milosrdnice", Zagreb, Croatia.
Coll Antropol. 2009 Mar;33(1):57-63.
The aim of this retrospective study was to evaluate the demographics and clinical characteristics of patients with pulmonary embolism treated in medical intensive care unit (ICU) at the University Hospital during a six-year period, and to assess the impact of several risk factors on patients' survival. The study included 165 patients, mean age 69.3 +/- 13.7 years, predominantly female (70.3%). Dominant symptom was dyspnea (97.0%), the most common sign tachypnea (69.6%). Pulmonary embolism was confirmed by high-probability ventilation/perfusion lung scan or multidetector computed tomography in 71.5% and was regarded as massive in 63 (38.2%), submassive in 23 (13.9%) and non massive in 79 patients (47.9%). Mean hospital stay was 5.7 +/- 4.4 days for ICU, and 14.8 +/- 9.1 days, overall. The ICU mortality was 26.7% and in-hospital mortality 30.9%. No statistical difference in mortality between male and female patients was observed (30.6% and 31.0%, respectively; p = 0.965), but prolonged immobilization (p = 0.002), recent operation (p = 0.034) or malignancy (p = 0.009) were shown to influence the outcome. Although a number of risk factors for developing pulmonary embolism have been identified and heparin prophylaxis along with early mobilization proposed to reduce the incidence, pulmonary embolism remains an important clinical problem with high mortality rate. The diagnostics should not wait and the therapy should start as soon as possible.
这项回顾性研究的目的是评估大学医院医疗重症监护病房（ICU）在六年期间治疗的肺栓塞患者的人口统计学和临床特征，并评估几种风险因素对患者生存的影响。该研究纳入了165例患者，平均年龄69.3±13.7岁，以女性为主（70.3%）。主要症状为呼吸困难（97.0%），最常见体征为呼吸急促（69.6%）。71.5%的患者通过高概率通气/灌注肺扫描或多排螺旋计算机断层扫描确诊为肺栓塞，其中63例（38.2%）为大面积肺栓塞，23例（13.9%）为次大面积肺栓塞，79例（47.9%）为非大面积肺栓塞。ICU的平均住院时间为5.7±4.4天，总体平均住院时间为14.8±9.1天。ICU死亡率为26.7%，住院死亡率为30.9%。未观察到男性和女性患者死亡率的统计学差异（分别为30.6%和31.0%；p = 0.965），但长期制动（p = 0.002）、近期手术（p = 0.034）或恶性肿瘤（p = 0.009）被证明会影响预后。尽管已经确定了许多发生肺栓塞 的风险因素，并提出肝素预防和早期活动以降低发病率，但肺栓塞仍然是一个重要的临床问题，死亡率很高。诊断不应等待，治疗应尽早开始。
