Wang Z Z, Han K N, Li J, Gao Y, Guo W, Xie J, Liu S
Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
The 12th Ward, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2023 Feb 12;46(2):137-143. doi: 10.3760/cma.j.cn112147-20221011-00810.
To analyze the clinical characteristics and to explore the prognostic factors of acute pulmonary embolism(APE) with newly diagnosed atrial fibrillation(AF). The medical records of inpatients with APE discharged from Beijing Anzhen Hospital between January 1, 2008, and December 31, 2021 were retrospectively reviewed. The clinical symptoms, complications, laboratory results, echocardiographic parameters, simplified pulmonary embolism severity index (sPESI) and adverse in-hospital outcome were compared between the newly diagnosed AF group and the sinus rhythm group. Logistic regression analysis was used to evaluate the risk factors of adverse in-hospital outcome with APE. Fifty-one patients were included in newly diagnosed AF group and 102 cases in the sinus rhythm group. The patients in newly diagnosed AF group had greater sPESI scores, higher proportion of sPESI≥2 scores, higher incidence of adverse in-hospital outcome as well as longer hospital stay days. Newly diagnosed AF and sPESI≥2 scores were independent predictors affecting adverse in-hospital outcome. The area under ROC curve in newly diagnosed AF combined with sPESI≥2 scores was largest. The APE patients with newly diagnosed AF were more severely ill and prone to in-hospital adverse outcome. Newly diagnosed AF was an independent predictor affecting adverse in-hospital outcome. sPESI≥2 combined with newly diagnosed AF scores had a high predictive value for the occurrence of in-hospital adverse outcome.
分析急性肺栓塞（APE）合并新诊断房颤（AF）的临床特征并探讨其预后因素。回顾性分析2008年1月1日至2021年12月31日在北京安贞医院出院的APE住院患者的病历。比较新诊断房颤组和窦性心律组的临床症状、并发症、实验室检查结果、超声心动图参数、简化肺栓塞严重程度指数（sPESI）及院内不良结局。采用Logistic回归分析评估APE院内不良结局的危险因素。新诊断房颤组纳入51例患者，窦性心律组纳入102例。新诊断房颤组患者的sPESI评分更高、sPESI≥2分的比例更高、院内不良结局发生率更高以及住院天数更长。新诊断房颤和sPESI≥2分是影响院内不良结局的独立预测因素。新诊断房颤联合sPESI≥2分的ROC曲线下面积最大。新诊断房颤的APE患者病情更严重，更容易出现院内不良结局。新诊断房颤是影响院内不良结局的独立预测因素。sPESI≥2联合新诊断房颤评分对院内不良结局的发生具有较高的预测价值。
