Alpert J S, Smith R, Carlson J, Ockene I S, Dexter L, Dalen J E
JAMA. 1976 Sep 27;236(13):1477-80.
The hospital course of 144 consecutive patients with pulmonary embolism (PE) demonstrated by pulmonary angiography was reviewed to determine the mortality of patients with treated PE. Twelve patients (8%) died of PE, and eight died of causes other than PE; 124 (86%) survived. Pulmonary embolism was the primary cause of death in only four of the 12 patients who died of PE. Pulmonary embolism contributed to the death of eight other patients, each of whom had associated potentially lethal disease, particularly heart disease. The most important factor affecting mortality was shock due to acute right ventricular failure secondary to massive PE (mortality, 32%). Mortality was not related to magnitude of PE per se; the mortality of patients with massive PE without shock (6%) was the same as that for patients with submassive PE (5%. Patients with PE who survive long enough to have the diagnosis established and appropriate prophylactic therapy begun have an excellent prognosis, unless they have associated severe medical disease.
回顾了连续144例经肺血管造影证实患有肺栓塞（PE）患者的住院病程，以确定接受治疗的PE患者的死亡率。12例患者（8%）死于PE，8例死于PE以外的原因；124例（86%）存活。在死于PE的12例患者中，仅4例的主要死因是肺栓塞。肺栓塞导致另外8例患者死亡，这些患者均伴有潜在的致命性疾病，尤其是心脏病。影响死亡率的最重要因素是大面积PE继发急性右心室衰竭所致的休克（死亡率为32%）。死亡率与PE本身的严重程度无关；无休克的大面积PE患者的死亡率（6%）与次大面积PE患者的死亡率（5%）相同。存活时间足够长以确诊并开始适当预防性治疗的PE患者预后良好，除非他们伴有严重的内科疾病。
