Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism

Background: To explore the differences in short and middle term adverse factors of pulmonary embolism (PE) outcome. Methods: This was a single-center retrospective study of inpatients admitted from Zhongshan Hospital, Fudan University, with first-time PE. Clinical data were collected from patients w...

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Main Authors: Xin Liu, Suchi Chang, Cuiping Fu, Zhirong Huo, Jing Zhou, Chengying Liu, Shanqun Li, Aijun Sun
Format: Article
Language:English
Published: SAGE Publishing 2017-08-01
Series:Therapeutic Advances in Respiratory Disease
Online Access:https://doi.org/10.1177/1753465817717168
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spelling doaj-df54e8761d7848de8b1fd73f9f88a0432020-11-25T02:54:19ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662017-08-011110.1177/1753465817717168Predictors of mid-term prognosis and adverse factors in acute pulmonary embolismXin LiuSuchi ChangCuiping FuZhirong HuoJing ZhouChengying LiuShanqun LiAijun SunBackground: To explore the differences in short and middle term adverse factors of pulmonary embolism (PE) outcome. Methods: This was a single-center retrospective study of inpatients admitted from Zhongshan Hospital, Fudan University, with first-time PE. Clinical data were collected from patients with objectively confirmed PE, and a 2-year follow up was conducted. Results: The sample contained 310 patients with PE, ranging in age from 18 to 86 years old (mean 63.28 ± 15.30) and including 165 men (53.2%) and 145 women (46.8%). Successful treatment was achieved in 285 cases (91.9%) and unsuccessful treatment turned out in 25 cases (8.1%). Logistical regression analysis showed that massive PE [odds ratio (OR) = 23.625, 95% confidence interval (CI) 6.248–89.333], hypoxemia (OR = 11.915, 95% CI 1.900–74.727), leukocytosis (OR = 9.120, 95% CI 2.227–37.349) and active cancer (OR = 6.142, 95% CI 1.233–30.587) were associated with a poor prognosis for acute PE in the short term (in hospital). Seventy-seven PE cases with complete electronic records were finally included in the follow up. Cox regression analysis showed that elevated pulmonary artery systolic pressure (PASP, ⩾50 mmHg) (HR = 9.240, 95% CI, 2.307–37.013) and active cancer with PE (HR = 3.700, 95% CI, 1.010–13.562) were associated with an increased risk of mid-term mortality after a follow-up period of 2 years. Conclusions: Massive PE, hypoxemia, leukocytosis and active cancer may contribute to a poor prognosis for patients with acute PE in hospital. Elevated PASP and active cancer may negatively impact survival time and increase the risk of death for patients with acute PE after 2-year follow up. Short-term adverse factors of acute PE are not exactly the same as the mid-term risk factors of acute PE.https://doi.org/10.1177/1753465817717168
collection DOAJ
language English
format Article
sources DOAJ
author Xin Liu
Suchi Chang
Cuiping Fu
Zhirong Huo
Jing Zhou
Chengying Liu
Shanqun Li
Aijun Sun
spellingShingle Xin Liu
Suchi Chang
Cuiping Fu
Zhirong Huo
Jing Zhou
Chengying Liu
Shanqun Li
Aijun Sun
Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
Therapeutic Advances in Respiratory Disease
author_facet Xin Liu
Suchi Chang
Cuiping Fu
Zhirong Huo
Jing Zhou
Chengying Liu
Shanqun Li
Aijun Sun
author_sort Xin Liu
title Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
title_short Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
title_full Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
title_fullStr Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
title_full_unstemmed Predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
title_sort predictors of mid-term prognosis and adverse factors in acute pulmonary embolism
publisher SAGE Publishing
series Therapeutic Advances in Respiratory Disease
issn 1753-4666
publishDate 2017-08-01
description Background: To explore the differences in short and middle term adverse factors of pulmonary embolism (PE) outcome. Methods: This was a single-center retrospective study of inpatients admitted from Zhongshan Hospital, Fudan University, with first-time PE. Clinical data were collected from patients with objectively confirmed PE, and a 2-year follow up was conducted. Results: The sample contained 310 patients with PE, ranging in age from 18 to 86 years old (mean 63.28 ± 15.30) and including 165 men (53.2%) and 145 women (46.8%). Successful treatment was achieved in 285 cases (91.9%) and unsuccessful treatment turned out in 25 cases (8.1%). Logistical regression analysis showed that massive PE [odds ratio (OR) = 23.625, 95% confidence interval (CI) 6.248–89.333], hypoxemia (OR = 11.915, 95% CI 1.900–74.727), leukocytosis (OR = 9.120, 95% CI 2.227–37.349) and active cancer (OR = 6.142, 95% CI 1.233–30.587) were associated with a poor prognosis for acute PE in the short term (in hospital). Seventy-seven PE cases with complete electronic records were finally included in the follow up. Cox regression analysis showed that elevated pulmonary artery systolic pressure (PASP, ⩾50 mmHg) (HR = 9.240, 95% CI, 2.307–37.013) and active cancer with PE (HR = 3.700, 95% CI, 1.010–13.562) were associated with an increased risk of mid-term mortality after a follow-up period of 2 years. Conclusions: Massive PE, hypoxemia, leukocytosis and active cancer may contribute to a poor prognosis for patients with acute PE in hospital. Elevated PASP and active cancer may negatively impact survival time and increase the risk of death for patients with acute PE after 2-year follow up. Short-term adverse factors of acute PE are not exactly the same as the mid-term risk factors of acute PE.
url https://doi.org/10.1177/1753465817717168
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