Lee Jun Sung, Moon Tong, Kim Tae Hoon, Kim Se Young, Choi Jun Young, Lee Kyung Bok, Kwon Yu Jin, Song Suk Hee, Kim Su Hyun, Kim Hae Ok, Hwang Ho Kyeong, Kim Min Ji, Lee Young Kyoung
Department of Surgery, Seoul Medical Center, Seoul, Korea.
Department of Internal medicine, Seoul Medical Center, Seoul, Korea.
Vasc Specialist Int. 2016 Dec;32(4):166-174. doi: 10.5758/vsi.2016.32.4.166. Epub 2016 Dec 31.
Deep venous thrombosis (DVT) and pulmonary embolism (PE) are considered as similar disease entities representing different clinical manifestations. The objectives of this study were: 1) to determine the prevalence and outcome of DVT in patients with PE; 2) to identify additional risk factors for PE-related unfavorable outcome and 30-day all-cause mortality; and 3) to establish the clinical importance of screening for concomitant DVT.
From January 2013 to December 2015, a total of 141 patients with confirmed PE were evaluated. The prevalence and outcome of DVT in patients with PE was determined. Furthermore, the potential risk factors for PE-related unfavorable outcome and 30-day all-cause mortality were also analyzed.
The prevalence of concomitant DVT was 45.4%. PE-related unfavorable outcome was observed in 21.9% of all concomitant DVT, with all-cause mortality of 21.9%. There was no significant relationship between the presence of concomitant DVT and the development of PE-related unfavorable outcome or all-cause mortality. Our results indicated that heart rate >100/min and peripheral oxygen saturation <90% were independent predictors for PE-related unfavorable outcome. Regarding all-cause mortality, active malignancy and hypotension or shock were significant risk factors.
Our findings demonstrate that approximately half of patients with PE possess DVT. However, this study failed to establish any clinical significance of concomitant DVT for PE-related unfavorable outcome and all-cause mortality. Tachycardia and hypoxemia were identified as significant predictors for PE-related unfavorable outcome along with active malignancy and hypotension or shock as significant risk factors of all-cause mortality.
深静脉血栓形成(DVT)和肺栓塞(PE)被视为代表不同临床表现的相似疾病实体。本研究的目的是:1)确定PE患者中DVT的患病率和结局;2)识别与PE相关的不良结局和30天全因死亡率的其他危险因素;3)确定筛查合并DVT的临床重要性。
2013年1月至2015年12月,共评估了141例确诊为PE的患者。确定了PE患者中DVT的患病率和结局。此外,还分析了与PE相关的不良结局和30天全因死亡率的潜在危险因素。
合并DVT的患病率为45.4%。在所有合并DVT的患者中,21.9%观察到与PE相关的不良结局,全因死亡率为21.9%。合并DVT的存在与PE相关不良结局或全因死亡率的发生之间无显著关系。我们的结果表明,心率>100次/分钟和外周血氧饱和度<90%是PE相关不良结局的独立预测因素。关于全因死亡率,活动性恶性肿瘤和低血压或休克是显著的危险因素。
我们的研究结果表明,约一半的PE患者患有DVT。然而,本研究未能确定合并DVT对PE相关不良结局和全因死亡率的任何临床意义。心动过速和低氧血症被确定为PE相关不良结局的重要预测因素,而活动性恶性肿瘤和低血压或休克是全因死亡率的重要危险因素。