Akhoundi Neda, Faghihi Langroudi Taraneh, Rezazadeh Elmira, Rajebi Hamid, Komijani Bozchelouei Javad, Sedghian Sonia, Sarfaraz Tohid, Heydari Negar
Department of Radiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
University of Texas Health at San Antonio, San Antonio, TX, USA.
Tanaffos. 2021 Feb;20(2):99-108.
Pulmonary embolism (PE) can be a possibly mortal disease; therefore, an immediate risk assessment would be imperative to ensure accurate decisions on proper treatment plans. The focus of the present study was to evaluate the prognostic value of clinical, echocardiographic, and helical pulmonary computed tomography angiography findings for adverse outcomes and mortality.
A total of 104 patients with PE were retrospectively entered in the present study. Patients were categorized into five groups, including patients who faced an adverse outcome (group 1), patients who expired in 30 days (group 2), patients who expired in 30-90 days (group 3), patients who expired in 90-180 days (group 4), and patients who survived without facing an adverse outcome (group 5). Comorbidities (e.g., malignancy) were obtained from medical records. Logistic regression analysis was performed to detect mortality predictors.
In this study, 16 patients were faced with an adverse outcome. Furthermore, 10, 5, and 2 deaths occurred within 30, 30-90, and 90-180 days, respectively. The most frequent presentation was dyspnea (89%). The mean intensive care unit stay (OR=1.202; P=0.036), the predicted 30-day mortality, and a history of kidney transplantation (OR=0.011; P=0.002) were related to less probability of death within 30 days.
The results of this study revealed that a history of kidney transplantation is independently accompanied by a lower occurrence of expiration in 30 days. Moreover, there was a significant correlation between the pulmonary embolism severity index, heart rate of > 100 beats per minute, chest pain, hypoxia, and pulmonary arterial pressure with the pulmonary artery obstruction index (PAOI).
肺栓塞（PE）可能是一种致命疾病；因此，进行即时风险评估对于确保就恰当的治疗方案做出准确决策至关重要。本研究的重点是评估临床、超声心动图和螺旋肺计算机断层扫描血管造影结果对不良结局和死亡率的预后价值。
本研究共纳入104例PE患者，采用回顾性研究方法。患者被分为五组，包括面临不良结局的患者（第1组）、30天内死亡的患者（第2组）、30至90天内死亡的患者（第3组）、90至180天内死亡的患者（第4组）以及未面临不良结局而存活的患者（第5组）。从病历中获取合并症（如恶性肿瘤）信息。进行逻辑回归分析以检测死亡率预测因素。
在本研究中，16例患者面临不良结局。此外，分别有10例、5例和2例患者在30天、30至90天和90至180天内死亡。最常见的表现是呼吸困难（89%）。平均重症监护病房住院时间（OR = 1.202；P = 0.036）、预测的30天死亡率以及肾移植史（OR = 0.011；P = 0.002）与30天内较低的死亡概率相关。
本研究结果显示，肾移植史与30天内较低的死亡率独立相关。此外，肺栓塞严重程度指数、心率>100次/分钟、胸痛、低氧血症和肺动脉压与肺动脉阻塞指数（PAOI）之间存在显著相关性。
