Changes in clinical signs and laboratory indicators and their risk-tiering diagnostic effectiveness in elderly patients with pulmonary embolization with different risk levels
10.3760/cma.j.issn.0254-9026.2021.07.007
- VernacularTitle:临床体征及实验室检测指标在不同危险等级老年肺栓塞患者间的变化及其分层诊断效能
- Author:
Pengbo YANG
1
;
Hexin LI
;
Bingqing HAN
;
Ye LIU
;
Xiaomao XU
Author Information
1. 北京医院检验科 国家老年医学中心 中国医学科学院老年医学研究院 100730
- Keywords:
Pulmonary embolism;
Risk stratification;
Clinical laboratory test;
Signs and symptoms
- From:
Chinese Journal of Geriatrics
2021;40(7):847-852
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes in clinical signs and laboratory testing results and their risk-tiring diagnostic effectiveness in elderly patients with pulmonary embolization (PE) with different risk levels.Methods:A retrospective analysis was conducted on the clinical data of elderly hospitalized PE patients in Beijing Hospital and other coordinated hospital from 2012 to 2020.Differences in 43 clinical signs and detection indicators between patients with four different risk levels were compared.The univariate and multivariate regression models were used to analyze differences between high-risk and non-high-risk PE and between intermediate-risk and low-risk PE with ROC analysis.Results:In the multi-group comparison, there are 33 clinical tests having significant differences between four risk groups, 29 clinical tests having significant differences between three risk groups(high, intermediate and low groups), and 21 clinical tests having significant differences between two groups(high and non-high groups). In the ROC analysis of risk stratification in high-risk and non-high-risk groups, it was found that the range of area under the curves(AUC)of 14 significantly changed clinical tests were 0.611 to 0.802 in the univariate regression analysis.The AUC of the model of systolic blood pressure(SBP)combined with white blood cell count(WBC)and aspartate aminotransferase(AST)was 0.8593(95% CI: 0.795-0.924)in the multivariate regression analysis.While in the ROC analysis between intermediate-risk and low-risk, the range of AUC of 12 significantly changed clinical tests were 0.592 to 0.835 in the univariate regression analysis.The B-type natriuretic peptide(BNP)and N-terminal B-type natriuretic peptide(NT-proBNP)can assist the risk stratification in intermediate-risk and low-risk PE groups.No efficient combined diagnosis model was found. Conclusions:The basic vital signs and multiple clinical laboratory tests were significantly different among four risk levels of elderly PE patients, such as blood gas analysis, coagulative function, liver and kidney function and myocardial markers.The combination of SBP, WBC, and AST can effectively assist the risk stratification in high-risk and non-high-risk PE groups.
