Zhang Jiarui, Zhou Haixia, Aili Adila, Wang Maoyun, Shen Yongchun, Yi Qun
Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.
J Thorac Dis. 2021 Feb;13(2):541-551. doi: 10.21037/jtd-20-2552.
Pleural effusion is observed in a subset of patients with acute pulmonary embolism (APE) and may be linked to clinical outcome, but findings from previous studies have been inconsistent. This study aimed to investigate the prevalence and clinical significance of pleural effusion in Chinese patients with APE.
Clinical data from hospitalized patients with APE were retrospectively collected and the prevalence of pleural effusion was determined. The relationship between the presence of pleural effusion and clinical outcome of APE was analyzed by Cox proportional hazards regression and Kaplan-Meier survival analysis.
The study enrolled 635 patients with APE. The prevalence of pleural effusion was 57.01% (362/635). Patients with pleural effusion had significantly higher in-hospital mortality (9.9% 4.8%, P<0.05) and longer length of hospital stay (LOS) (19.99 15.31 days, P<0.05) than whose without pleural effusion. However, pleural effusion was not an independent risk factor for in-hospital mortality in patients with APE by multivariate Cox proportional hazards regression analysis [hazard ratio (HR) =1.70, 95% confidence interval (CI): 0.73-3.92, P=0.216] and Kaplan-Meier survival analysis (P=0.174).
Pleural effusion is a frequent occurrence in patients with APE and therefore merits greater attention from clinicians; however, it is not an independent risk factor for in-hospital mortality.
在一部分急性肺栓塞(APE)患者中可观察到胸腔积液,其可能与临床结局相关,但既往研究结果并不一致。本研究旨在调查中国APE患者胸腔积液的患病率及其临床意义。
回顾性收集住院APE患者的临床资料,确定胸腔积液的患病率。采用Cox比例风险回归分析和Kaplan-Meier生存分析,分析胸腔积液与APE临床结局之间的关系。
本研究纳入了635例APE患者。胸腔积液的患病率为57.01%(362/635)。与无胸腔积液的患者相比,有胸腔积液的患者院内死亡率显著更高(9.9%对4.8%,P<0.05),住院时间更长(19.99天对15.31天,P<0.05)。然而,通过多变量Cox比例风险回归分析[风险比(HR)=1.70,95%置信区间(CI):0.73-3.92,P=0.216]和Kaplan-Meier生存分析(P=0.174),胸腔积液并非APE患者院内死亡的独立危险因素。
胸腔积液在APE患者中很常见,因此值得临床医生更多关注;然而,它并非院内死亡的独立危险因素。