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德国住院肺栓塞患者的死亡率及与院内死亡率相关的因素。

Mortality rate and factors associated with in-hospital mortality in patients hospitalized with pulmonary embolism in Germany.

机构信息

IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany.

University Clinic, Philipps-University, 35043, Marburg, Germany.

出版信息

J Thromb Thrombolysis. 2024 Oct;57(7):1154-1162. doi: 10.1007/s11239-024-03036-4. Epub 2024 Aug 23.

DOI:10.1007/s11239-024-03036-4
PMID:39179949
Abstract

Pulmonary embolism (PE) is a life-threatening condition, the prognosis of which is determined in particular by acute decompensation and hospitalization. The goal of this study was to investigate the prevalence of and the factors associated with the in-hospital mortality of patients hospitalized with acute PE. This multicenter cross-sectional study was based on the data of PE patient cases from 36 hospitals across Germany. A multivariable logistic regression analysis was conducted to assess the associations between demographic and clinical variables and in-hospital mortality. A total of 7136 hospitalization cases were included (mean age: 68.6 years, 49.2% female). 60.2% of patients received PE as primary and 39.8% as secondary diagnosis. The mortality rate was 13.2%. Age group 71-80 years (OR: 1.49; 95% CI: 1.18-1.88) and > 80 years (OR: 2.06; 95% CI: 1.61-2.62), PE as secondary diagnosis (OR: 2.12; 95% CI: 1.676-2.56), respiratory failure (OR: 2.88; 95% CI: 2.44-3.41), acute renal failure (OR: 2.65; 95% CI: 2.14-3.27), hypokalemia (OR: 1.51; 95% CI: 1.28-1.79), heart failure (OR: 1.43; 95% CI: 1.18-1.73), and acute posthemorrhagic anemia (OR: 1.34; 95% CI: 1.04-1.74) were associated with an increased mortality risk. Our findings underscore the significant impact of age, acute renal failure, and respiratory complications on the mortality of patients with PE. While our study provides a comprehensive snapshot of in-hospital mortality in acute PE patients, it also highlights the need for ongoing research to deepen our understanding of the interplay between various risk factors.

摘要

肺栓塞(PE)是一种危及生命的疾病,其预后尤其取决于急性失代偿和住院治疗。本研究的目的是调查因急性 PE 住院患者的住院死亡率的发生率及其相关因素。这是一项多中心横断面研究,基于德国 36 家医院的 PE 患者病例数据。采用多变量逻辑回归分析评估人口统计学和临床变量与住院死亡率之间的关系。共纳入 7136 例住院病例(平均年龄:68.6 岁,49.2%为女性)。60.2%的患者将 PE 作为主要诊断,39.8%作为次要诊断。死亡率为 13.2%。年龄组 71-80 岁(OR:1.49;95%CI:1.18-1.88)和>80 岁(OR:2.06;95%CI:1.61-2.62)、PE 作为次要诊断(OR:2.12;95%CI:1.676-2.56)、呼吸衰竭(OR:2.88;95%CI:2.44-3.41)、急性肾功能衰竭(OR:2.65;95%CI:2.14-3.27)、低钾血症(OR:1.51;95%CI:1.28-1.79)、心力衰竭(OR:1.43;95%CI:1.18-1.73)和急性出血后贫血(OR:1.34;95%CI:1.04-1.74)与死亡风险增加相关。我们的研究结果强调了年龄、急性肾功能衰竭和呼吸并发症对 PE 患者死亡率的重大影响。虽然我们的研究提供了急性 PE 患者住院死亡率的综合情况,但也突出了需要进行持续研究,以加深我们对各种风险因素相互作用的理解。

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