Abuelhassan Usama E, Alsalem Ali A, Alshafa Fawwaz A, Alshahrani Fahad S, AlShahrani Maram A, ALAmri Amal K, Alaqil Meaad A, Al Asim Ahmad Ali, Alsultan Eman M, Al Mani Salihah Y, Badawi Azizah G, Alshehri Elham F, Alshehri Eissa A, ALAmri Nour K, Abdalla Abdelrahman M, Khalaf Mervat, Ghalyoob Tayseer M, Elnamaky Medhat, Mahmoud Ibrahim M
Department of Internal Medicine, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, SAU.
Department of Respiratory Medicine, Faculty of Medicine, Cairo University, Cairo, EGY.
Cureus. 2024 Mar 6;16(3):e55623. doi: 10.7759/cureus.55623. eCollection 2024 Mar.
We aimed to investigate the clinical characteristics, outcomes, and mortality predictors in patients with acute pulmonary embolism (PE). Adult patients who were admitted to the Armed Forces Hospital Southern Region, Khamis Mushait, a large tertiary hospital in Southern Saudi Arabia, with the diagnosis of acute PE were retrospectively examined for the predictors of one-year mortality.
The overall in-hospital mortality was 15.6% among 212 patients. In univariate analysis, only age was significantly associated with increased early mortality, whereas age, obesity, presence of active malignancy, hypertension, use of thrombolytics, and Simplified Pulmonary Embolism Severity Index (sPESI) were significantly associated with increased late mortality. By use of binary logistic regression, the presence of obesity (HR 6.010, 95%CI 0.048-16.853, p=0.030), active malignancy (HR 3.040, 95%CI 1.147-8.059, p=0.025), and the use of thrombolytics (HR 8.074, 95%CI 2.719-23.977, p<0.001), were independently significant factors for late (overall) mortality, respectively.
Among Saudi Arabian patients in the Southern Region, our data show that age is an independent factor for increased early and late mortality. The presence of obesity, active malignancy, and the use of thrombolytics, were independently significant factors for increased late (one-year) mortality. These factors should be taken into account for risk stratification and decisions on tailored management of patients with PE. Further prospective multicenter studies are needed.
我们旨在研究急性肺栓塞（PE）患者的临床特征、转归及死亡预测因素。对沙特阿拉伯南部一家大型三级医院——哈米斯穆谢特南部地区武装部队医院收治的诊断为急性PE的成年患者进行回顾性研究，以确定一年死亡率的预测因素。
212例患者的院内总死亡率为15.6%。单因素分析中，仅年龄与早期死亡率增加显著相关，而年龄、肥胖、存在活动性恶性肿瘤、高血压、使用溶栓药物及简化肺栓塞严重程度指数（sPESI）与晚期死亡率增加显著相关。通过二元逻辑回归分析，肥胖（HR 6.010，95%CI 0.048 - 16.853，p = 0.030）、活动性恶性肿瘤（HR 3.040，95%CI 1.147 - 8.059，p = 0.025）及使用溶栓药物（HR 8.074，95%CI 2.719 - 23.977，p < 0.001）分别是晚期（总体）死亡率的独立显著因素。
在沙特阿拉伯南部地区的患者中，我们的数据表明年龄是早期和晚期死亡率增加的独立因素。肥胖、活动性恶性肿瘤及使用溶栓药物是晚期（一年）死亡率增加的独立显著因素。在对PE患者进行风险分层及制定个体化治疗决策时应考虑这些因素。还需要进一步的前瞻性多中心研究。
