Okeke Collins C, Amadi Emmanuel S, Ebiliekwe Onyinye E, Ekeocha Ifunanya R, Nnanna Okoro Emeka, Nduji Oluchi J, Undie Malipeh-Unim, Ngige Onyinye, Eze-Odurukwe Anthony, Ezema Chinecherem, Onyeogulu Afamefuna, Ojo Angela, Obuseh Michael, Okonta Kelechi
Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, NGA.
Department of Internal Medicine, Hallel Hospital and Maternity, Port Harcourt, NGA.
Cureus. 2024 Nov 28;16(11):e74673. doi: 10.7759/cureus.74673. eCollection 2024 Nov.
Pulmonary embolism is a common cause of morbidity and mortality. Numerous risk factors have been identified that predispose patients to this disease. This study aims to identify these risk factors and the possible outcomes (recovery or mortality) after receiving treatment from any hospital. Healthcare is expensive in Africa, hence hindering its easy accessibility. PubMed, Scopus, and African Journals Online were searched from the database inception to October 2024 to identify relevant studies. A total of 719 articles were identified, for which 172 duplicate articles were removed. After screening 592 articles by title and abstract, 508 were excluded. Eighty-four articles were screened by full text to determine their eligibility. Finally, 13 articles were used in the final qualitative analysis. We included original research published in English in peer-reviewed journals from January 2000 to September 2024 that reported the risk factors and outcomes of pulmonary embolism, and studies that used computed tomography pulmonary angiography as a diagnosis of acute pulmonary embolism in patients more than 18 years old, irrespective of gender and medical or surgical condition, managed in any African hospital, were included. In total, 7650 patients were included in 13 articles, from 10 countries (Nigeria, Togo, Angola, Kenya, Cameroon, South Africa, Sierra Leone, Egypt, DR Congo, and Ethiopia), and 861 patients had pulmonary embolism. The mean age of the reported patients ranged from 40.8 to 64.4 years across the studies. There were 309 male and 552 female patients diagnosed with pulmonary embolism. The study types included in this review are retrospective studies, cross-sectional studies, and case-control studies. Deep vein thrombosis (DVT), heart disease, immobilization, obesity, smoking, recent surgery, and malignancy were the most commonly identified risk factors across the included articles. Pulmonary embolism contributes significantly to morbidity and mortality among African patients, with key risk factors including DVT, immobilization, heart disease, obesity, smoking, recent surgery, malignancy, pregnancy, and contraceptive use. Limited diagnostic resources in low-resource settings pose a major challenge, but adopting affordable diagnostic alternatives and clinical algorithms could improve outcomes by enabling earlier diagnosis and timely treatment. The availability and implementation of a standardized PE treatment protocol will ensure quality care, decrease mortality, and increase recovery rates.
肺栓塞是发病和死亡的常见原因。已确定了许多使患者易患此病的危险因素。本研究旨在确定这些危险因素以及在任何医院接受治疗后的可能结果（康复或死亡）。在非洲，医疗费用高昂，因此阻碍了人们轻松获得医疗服务。从数据库创建到2024年10月，对PubMed、Scopus和非洲在线期刊进行了检索，以确定相关研究。共识别出719篇文章，其中172篇重复文章被剔除。通过标题和摘要筛选592篇文章后，排除了508篇。对84篇文章进行全文筛选以确定其是否符合要求。最后，13篇文章用于最终的定性分析。我们纳入了2000年1月至2024年9月在同行评审期刊上发表的英文原创研究，这些研究报告了肺栓塞的危险因素和结果，以及使用计算机断层扫描肺动脉造影诊断18岁以上患者急性肺栓塞的研究，无论性别、医疗或手术状况如何，在任何非洲医院接受治疗的患者均纳入研究。13篇文章共纳入7650例患者，来自10个国家（尼日利亚、多哥、安哥拉、肯尼亚、喀麦隆、南非、塞拉利昂、埃及、刚果民主共和国和埃塞俄比亚），其中861例患有肺栓塞。各研究中报告患者的平均年龄在40.8岁至64.4岁之间。诊断为肺栓塞的患者有309名男性和552名女性。本综述纳入的研究类型包括回顾性研究、横断面研究和病例对照研究。在所纳入的文章中，深静脉血栓形成（DVT）、心脏病、制动、肥胖、吸烟、近期手术和恶性肿瘤是最常确定的危险因素。肺栓塞对非洲患者的发病率和死亡率有重大影响，主要危险因素包括DVT、制动、心脏病、肥胖、吸烟、近期手术、恶性肿瘤、妊娠和避孕药使用。资源匮乏地区有限的诊断资源构成了重大挑战，但采用经济实惠的诊断替代方法和临床算法可通过实现早期诊断和及时治疗来改善结果。标准化肺栓塞治疗方案的可用性和实施将确保优质护理、降低死亡率并提高康复率。
