Cardiologia- Ospedale San Carlo Borromeo, Milan, Italy.
Thromb Res. 2012 Dec;130(6):847-52. doi: 10.1016/j.thromres.2012.08.292. Epub 2012 Aug 24.
Registries are essential to obtain information on the whole spectrum of patients with pulmonary embolism (PE). The aim of the Italian Pulmonary Embolism Registry (IPER) is to report on demographics, clinical features, management, and outcomes of patients diagnosed with PE in everyday clinical practice.
Patients with confirmed acute PE were enrolled in a web-based registry, in Cardiology, Emergency or Internal Medicine Departments in 47 hospitals in Italy.
Overall, 1716 patients were included, mean age 70 ± 15 years, (14% of the patients were <50 and 43% >75 year old); 57% of female gender and 11.7% hemodynamically unstable at presentation/diagnosis. D-dimer was performed in 1358 patients (80%). Computerized tomographic pulmonary angiogram (CT) was used for diagnosis in the majority of the patients (82.1%), followed by perfusion lung scan (8.6%). Thrombolytic agents were used in 185 (10.8%) patients, percutaneous thrombectomy in 14 (0.8%) and surgery in 2 (0.1%). One hundred sixteen patients died while in-hospital (6.7%), 68 (3.9%) due to PE. Death or clinical deterioration occurred in 138 patients (8.0%). All-cause mortality was 31.8% in hemodynamically unstable patients and 3.4% in hemodynamically stable patients; the corresponding PE-related deaths were 23.3% and 1.4% respectively. Age >75 (HR 1.50, 95% CI 1.01-2.25), immobilization > 3 days before diagnosis of PE (HR 2.54, 95% CI 1.72-3.77) and hemodynamic impairment (HR 6.38, 95% CI 4.26-9.57) were independent predictors for in-hospital death.
Patients with PE have a considerable risk of death during the hospital stay, PE being the most common cause of early mortality.
注册是获取肺栓塞（PE）全谱患者信息的必要手段。意大利肺栓塞注册研究（IPER）的目的是报告在意大利 47 家医院的心脏病学、急诊或内科部门，在日常临床实践中诊断为 PE 的患者的人口统计学、临床特征、管理和结局。
在一个基于网络的注册系统中，纳入了确诊为急性 PE 的患者。
共纳入 1716 例患者，平均年龄 70 ± 15 岁（14%的患者年龄<50 岁，43%的患者年龄>75 岁）；女性占 57%，11.7%患者就诊/诊断时血流动力学不稳定。1358 例患者（80%）进行了 D-二聚体检测。大多数患者（82.1%）采用计算机断层肺动脉造影（CT）进行诊断，其次是灌注肺扫描（8.6%）。185 例患者（10.8%）使用溶栓药物，14 例（0.8%）采用经皮血栓切除术，2 例（0.1%）采用手术治疗。116 例患者住院期间死亡（6.7%），68 例（3.9%）死于 PE。138 例患者（8.0%）死亡或病情恶化。血流动力学不稳定患者的全因死亡率为 31.8%，血流动力学稳定患者的全因死亡率为 3.4%；相应的 PE 相关死亡率分别为 23.3%和 1.4%。年龄>75 岁（HR 1.50，95%CI 1.01-2.25）、PE 诊断前制动>3 天（HR 2.54，95%CI 1.72-3.77）和血流动力学损害（HR 6.38，95%CI 4.26-9.57）是住院期间死亡的独立预测因素。
PE 患者在住院期间有相当大的死亡风险，PE 是早期死亡的最常见原因。
