Adila Aili, Tang Y J, Zhang J R, Liu Y, Peng L G, Pu J Q, Wang M Y, Wang L, Zhou H X, Yi Qun
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Leshan Vocational and Technical College, Leshan 613100, China.
Zhonghua Yi Xue Za Zhi. 2022 May 17;102(18):1374-1378. doi: 10.3760/cma.j.cn112137-20210824-01922.
To explore the association between syncope and poor prognosis and related factors of syncope in patients with acute pulmonary embolism (APE). A total of 740 patients with first diagnosed APE treated in West China Hospital of Sichuan University from September 1, 2016 to December 30, 2019 were enrolled. The basic information and clinical information (including clinical manifestations, complications, auxiliary examination, treatment and prognosis, etc.) of the patients were obtained from inpatient medical records. The patients were divided into the syncope group and the non-syncope group according to whether they had syncope or not. The basic and clinical conditions of the two groups were compared, and the factors related to syncope in APE patients were analyzed by multiple logistic regression model. The proportion of APE patients with syncope was 12.6% (93/740). Age was (59±16) years in the syncope group (93 cases) and (59±17) years in the non-syncope group (647 cases), with 57.0% (53/93) and 60.4% (391/647) males, respectively. The body mass index, in-hospital mortality, proportions with high risk APE and mechanical ventilation of the syncope group were higher than those of the non-syncope group [(24.5±4.0) kg/m vs (23.3±3.8) kg/m, 16.1% vs 7.7%, 4.4% vs 1.3% and 9.7% vs 2.5%, respectively]. The length of hospital stay [ (, )] of the syncope group was longer than that of the non-syncope group [15 (10, 22) d vs 14 (9, 22) d], and the proportions with chest pain and hemoptysis were lower than those of the non-syncope group (19.4% vs 36.8% and 14.0% vs 27.2%, respectively) (all values<0.05). Multivariate logistic regression analysis showed that enlargement of the right heart [ (95%): 2.46 (1.07, 5.64)] was a factor associated with syncope in APE patients. The proportion of APE patients with syncope is relatively high and is associated with poor prognosis, while enlargement of the right heart is associated with syncope in APE patients.
探讨急性肺栓塞(APE)患者晕厥与预后不良的关系及晕厥的相关因素。选取2016年9月1日至2019年12月30日在四川大学华西医院首次确诊为APE并接受治疗的740例患者。从住院病历中获取患者的基本信息和临床信息(包括临床表现、并发症、辅助检查、治疗及预后等)。根据患者是否有晕厥将其分为晕厥组和非晕厥组。比较两组的基本情况和临床状况,并通过多因素logistic回归模型分析APE患者晕厥的相关因素。APE患者中晕厥的比例为12.6%(93/740)。晕厥组(93例)患者年龄为(59±16)岁,非晕厥组(647例)患者年龄为(59±17)岁,男性比例分别为57.0%(53/93)和60.4%(391/647)。晕厥组的体重指数、院内死亡率、高危APE比例及机械通气比例均高于非晕厥组[分别为(24.5±4.0)kg/m² 对 (23.3±3.8)kg/m²、16.1% 对 7.7%、4.4% 对 1.3%、9.7% 对 2.5%]。晕厥组的住院时间[(,)]长于非晕厥组[15(10,22)d 对 14(9,22)d],胸痛和咯血比例低于非晕厥组(分别为19.4% 对 36.8%、14.0% 对 27.2%)(均P值<0.05)。多因素logistic回归分析显示,右心扩大[比值比(95%置信区间):2.46(1.07,5.64)]是APE患者晕厥的相关因素。APE患者中晕厥比例相对较高且与预后不良相关,而右心扩大与APE患者晕厥相关。