Ye Wenjing, Chen Xi, Li Xiaoming, Guo Xuejun, Gu Wen
Department of Respiratory Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Respiratory Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Respir Med. 2022 Feb 26;195:106794. doi: 10.1016/j.rmed.2022.106794.
Risk stratification for acute pulmonary embolism (PE) ignores the roles of respiratory function and gas exchange. We aimed to identify the role of arterial partial pressure of oxygen (PO) and diffusion function as prognostic biomarkers.
We collected the data from hospitalised patients with acute PE. We used Spearman's correlation coefficient and Cox regression analysis to explore the clinical and prognostic values of PO and predicted percentage diffusing lung capacity for carbon monoxide (DLCO%pred) to predict the 30-day mortality.
We included 309 patients (mean age: 67.93 ± 13.31 years); 46.6% were men, and 12.62% were haemodynamically unstable. The 30-day all-cause mortality rates in the high-, intermediate high-, intermediate low-, and low-risk groups were 7.7%, 4.7%, 2.9%, and 0.0%, respectively (P < 0.05). PO (P = 0.012) and DLCO%pred (P = 0.036) were significantly different between the four risk groups. There were strong correlations between PO, DLCO%pred, PODLCO%pred, and other markers (P < 0.05), especially troponin I, N-terminal pro-brain natriuretic peptide, and systolic pulmonary artery pressure. PO and PODLCO%pred were prognostic factors for death in haemodynamically stable patients (hazard ratio [HR] 0.618, 95% confidence interval [CI] 0.389-0.980, P = 0.041, and HR 0.501, 95% CI 0.26-0.96, P = 0.036, respectively). A lower PO (<8 kPa) was associated with a higher risk of mortality in all patients and in haemodynamically stable ones (HR 9.462, 95% CI 2.365-37.860, P = 0.001, and HR 6.597, 95% CI 1.102-39.495, P = 0.039, respectively).
PO, PO*DLCO%pred, and PO < 8 kPa were predictors of 30-day all-cause mortality in all patients and haemodynamically stable ones.
ChiCTR2000030448.
急性肺栓塞（PE）的风险分层忽略了呼吸功能和气体交换的作用。我们旨在确定动脉血氧分压（PO）和弥散功能作为预后生物标志物的作用。
我们收集了住院急性PE患者的数据。我们使用Spearman相关系数和Cox回归分析来探讨PO和预测的一氧化碳弥散肺容量百分比（DLCO%pred）对预测30天死亡率的临床和预后价值。
我们纳入了309例患者（平均年龄：67.93±13.31岁）；46.6%为男性，12.62%血流动力学不稳定。高、中高、中低和低风险组的30天全因死亡率分别为7.7%、4.7%、2.9%和0.0%（P<0.05）。四个风险组之间的PO（P=0.012）和DLCO%pred（P=0.036）有显著差异。PO、DLCO%pred、PODLCO%pred与其他标志物之间存在强相关性（P<0.05），尤其是肌钙蛋白I、N末端脑钠肽前体和收缩期肺动脉压。PO和PODLCO%pred是血流动力学稳定患者死亡的预后因素（风险比[HR]分别为0.618，95%置信区间[CI]0.389 - 0.980，P = 0.041；HR 0.501，95%CI 0.26 - 0.96，P = 0.036）。较低的PO（<8 kPa）与所有患者及血流动力学稳定患者的较高死亡风险相关（HR分别为9.462，95%CI 2.365 - 37.860，P = 0.001；HR 6.597，95%CI 1.102 - 39.495，P = 0.039）。
PO、PO*DLCO%pred以及PO<8 kPa是所有患者及血流动力学稳定患者30天全因死亡率的预测指标。
ChiCTR2000030448。
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