Andersson Therese, Söderberg Stefan
Department of Public Health and Clinical Medicine, Medicine, Umea University, -90187, Umeå, SE, Sweden.
BMC Cardiovasc Disord. 2017 Jun 14;17(1):155. doi: 10.1186/s12872-017-0587-1.
The aim of the study was to determine the incidence of acute pulmonary embolism (PE) in Sweden and any regional differences. To assess short- and long-term survival analysis after an episode of PE, before and after excluding patients with known malignancies, and to determine the most common comorbidities prior to the PE event.
All in-hospital patients, including children, diagnosed with acute PE in 2005 were retrieved from the Swedish National Patient Registry (NPR) and incidence rates were calculated. All registered comorbidities from 1998 until the index events were collected and survival up to 4 years after the event were calculated and compared to matched controls.
There were 5793 patients of all ages diagnosed with acute PE in 2005 resulting in a national incidence of 0.6/1000/year. The mean age was 70 years and 52% were women. The most frequent comorbidities were cardiac-, vascular-, infectious- and gastrointestinal diseases, injuries and malignancies. The mortality rates were more than doubled in patients with recent PE compared to that in a matched control group (49.1% vs 21.9%), and the excess mortality remained after exclusion of deaths occurring within one year and after exclusion of patients with any malignancy prior to the event.
PE is associated with high age as well as with multiple comorbidities, and with an increased short- and long-term mortality. This study highlights the importance of a proper follow-up after an acute PE.
本研究旨在确定瑞典急性肺栓塞(PE)的发病率及任何地区差异。评估PE发作后排除已知恶性肿瘤患者前后的短期和长期生存分析,并确定PE事件发生前最常见的合并症。
从瑞典国家患者登记处(NPR)检索2005年诊断为急性PE的所有住院患者(包括儿童),并计算发病率。收集1998年至索引事件期间所有登记的合并症,计算事件发生后长达4年的生存率,并与匹配的对照组进行比较。
2005年有5793名各年龄段患者被诊断为急性PE,全国发病率为0.6/1000/年。平均年龄为70岁,52%为女性。最常见的合并症是心脏、血管、感染和胃肠道疾病、损伤及恶性肿瘤。与匹配对照组相比,近期发生PE的患者死亡率增加了一倍多(49.1%对21.9%),排除事件发生后一年内的死亡病例以及排除事件发生前患有任何恶性肿瘤的患者后,额外死亡率仍然存在。
PE与高龄以及多种合并症相关,并伴有短期和长期死亡率增加。本研究强调了急性PE后进行适当随访的重要性。