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高海拔地区术后肺栓塞的预后

Prognosis of Postoperative Pulmonary Embolism in High Altitude.

作者信息

Alosaimi Fadi S, Al Sayed Osama H, Alhusayni Muhanna A, Alsubaie Abdulrahman, Algethami Abdullah Ibrahim M, Mahfouz Mohammad Eid M

机构信息

Medicine, Taif University, Taif, SAU.

Surgery, Taif University, Taif, SAU.

出版信息

Cureus. 2023 Oct 2;15(10):e46358. doi: 10.7759/cureus.46358. eCollection 2023 Oct.

Abstract

BACKGROUND

Pulmonary embolism (PE) is a common cause of death and serious disability, with risks that extend beyond the acute phase. Despite advances in diagnosis and treatment, high mortality rates remain a persistent problem.

AIM

The current study aimed to investigate PE prognosis and its determinants among native highlanders in Taif City, Saudi Arabia.

METHODS

This is a retrospective study where data was collected from the medical records of native high-altitude PE patients in Taif, Saudi Arabia, from 2017 to 2022.

RESULTS

The study included 154 native high-altitude PE patients with a mean age of 54±19 years. Most were females and nonsmokers (51.3% (n=79) and 89% (n=137), respectively). Of them, 28.6% (n=44) had undergone a previous surgery, and 61.4% (n=27) of these surgeries were within 1-3 weeks before hospital admission. The majority of patients had sub-massive PE (59.1% (n=91)), followed by non-massive PE (24% (n=37)) and massive PE (16.9% (n=26)). After management, 98 (63.6%) patients were improved, and 56 (36.4%) patients were not improved at the time of data collection. In terms of improvement after PE, patients who had undergone a previous surgery were less than those who had not, with no significant difference (56.8% (n=25) and 66.4% (n=73), respectively, p=0.266). All patients with heart rates (HRs) less than 70 bpm improved after PE compared to those with higher HRs (p=0.003). The thrombus location had no statistically significant association with patient outcomes (p=0.058).

CONCLUSION

This study provides valuable insights into patient outcomes at high altitudes after PE and the prognostic factors influencing these outcomes. It was identified that a low HR was associated with positive outcomes.

摘要

背景

肺栓塞(PE)是导致死亡和严重残疾的常见原因,其风险不仅局限于急性期。尽管在诊断和治疗方面取得了进展,但高死亡率仍然是一个持续存在的问题。

目的

本研究旨在调查沙特阿拉伯塔伊夫市本地高原居民的肺栓塞预后及其决定因素。

方法

这是一项回顾性研究,收集了2017年至2022年沙特阿拉伯塔伊夫市本地高原肺栓塞患者的病历数据。

结果

该研究纳入了154例本地高原肺栓塞患者,平均年龄为54±19岁。大多数为女性且不吸烟(分别为51.3%(n=79)和89%(n=137))。其中,28.6%(n=44)曾接受过手术,这些手术中有61.4%(n=27)是在入院前1-3周内进行的。大多数患者为次大面积肺栓塞(59.1%(n=91)),其次是非大面积肺栓塞(24%(n=37))和大面积肺栓塞(16.9%(n=26))。经过治疗后,98例(63.6%)患者病情好转,56例(36.4%)患者在数据收集时病情未改善。在肺栓塞后的改善情况方面,曾接受过手术的患者少于未接受过手术的患者,但差异无统计学意义(分别为56.8%(n=25)和66.4%(n=73),p=0.266)。与心率较高的患者相比,所有心率(HR)低于70次/分钟的患者在肺栓塞后病情均有所改善(p=0.003)。血栓位置与患者预后无统计学显著关联(p=0.058)。

结论

本研究为高原地区肺栓塞患者的预后及影响这些预后的因素提供了有价值的见解。研究发现低心率与良好预后相关。

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