Mutlu Hüseyin, Kokulu Kamil, Sert Ekrem Taha, Çağlar Ahmet
Department of Emergency Medicine, Aksaray Training and Research Hospital, Aksaray, Turkey.
School of Medicine, Aksaray University, Adana Yolu Üzeri E-90 Karayolu 7. Km, Aksaray, Turkey.
Heart Vessels. 2020 Jul;35(7):996-1002. doi: 10.1007/s00380-020-01568-2. Epub 2020 Feb 19.
Pulmonary thromboembolism (PTE) is an acute emergency with high mortality and morbidity rates. This study aimed to investigate the importance of Lipocalin-type prostaglandin D synthase (L-PGDS) in predicting mortality and prognosis in PTE. The study prospectively included 90 patients who were admitted to the emergency department and in whom PTE was confirmed by computed tomographic pulmonary angiography as well as 40 healthy volunteers with no disease. L-PGDS levels in the venous blood were measured and compared. Pulmonary embolism severity index (PESI) prognosis scores of all patients and 1-month mortality rate were calculated. There was a statistically significant difference between the L-PGDS levels of the patient and control groups (P = 0.024), and 1-month mortality of patients diagnosed with PTE was 20% (n = 18). Furthermore, the patients were divided into two groups: patients deceased within 1 month following the diagnosis and survivors. L-PGDS levels of the deceased patients were significantly higher than those of the survivors (P < 0.001). Age, systolic blood pressure, pulse, shock index, lactate, and PESI scores were significantly different between the survivors and deceased patients. The cut-off value for L-PGDS obtained using receiver operating characteristic (ROC) curve analysis for 1-month mortality was 815.26 ng/mL (sensitivity: 83.33%; specificity: 79.17%; area under the curve: 0.851; 95% confidence interval 0.760-0.917; P < 0.001). Based on this cut-off value, logistic regression analysis revealed that increased L-PGDS, together with PESI, was an independent indicator of 1-month mortality. L-PGDS is associated with short-term mortality in patients with PTE; therefore, it can be used to predict mortality risk in patients with PTE.
肺血栓栓塞症(PTE)是一种死亡率和发病率都很高的急性急症。本研究旨在探讨脂质运载蛋白型前列腺素D合成酶(L-PGDS)在预测PTE患者死亡率和预后方面的重要性。该研究前瞻性纳入了90例因PTE入住急诊科且经计算机断层扫描肺动脉造影确诊的患者以及40名无疾病的健康志愿者。测量并比较静脉血中的L-PGDS水平。计算所有患者的肺栓塞严重程度指数(PESI)预后评分和1个月死亡率。患者组和对照组的L-PGDS水平存在统计学显著差异(P = 0.024),诊断为PTE的患者1个月死亡率为20%(n = 18)。此外,将患者分为两组:诊断后1个月内死亡的患者和存活者。死亡患者的L-PGDS水平显著高于存活者(P < 0.001)。存活者和死亡患者之间的年龄、收缩压、脉搏、休克指数、乳酸和PESI评分存在显著差异。使用受试者工作特征(ROC)曲线分析得出的1个月死亡率的L-PGDS临界值为815.26 ng/mL(敏感性:83.33%;特异性:79.17%;曲线下面积:0.851;95%置信区间0.760 - 0.917;P < 0.001)。基于此临界值,逻辑回归分析显示,L-PGDS升高与PESI一起是1个月死亡率的独立指标。L-PGDS与PTE患者的短期死亡率相关;因此,它可用于预测PTE患者的死亡风险。