Analysis of clinical characteristics and prognosis in patients with hospital-acquired pulmonary embolism
10.3760/cma.j.cn115396-20240916-00280
- VernacularTitle:院内获得性肺栓塞患者的临床特征及预后情况分析
- Author:
Yunchao XING
1
;
Xueming CHEN
;
Hai FENG
Author Information
1. 首都医科大学附属北京友谊医院血管外科，北京 100050
- Keywords:
Pulmonary embolism;
Hospital mortality;
Prognosis;
Risk factors
- From:
International Journal of Surgery
2025;52(3):163-169
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of hospital-acquired pulmonary embolism(HA-PE) and identify the risk factors associated with in-hospital mortality.Methods:The retrospective cohort study was used. The clinical and follow-up data were collected of 60 patients with primary diseases who were admitted to the General Surgery Ward of Beijing Friendship Hospital affiliated to Capital Medical University from January 2015 to December 2021. These patients were planned for surgical treatment and were diagnosed with HA-PE during their hospitalization. A total of 60 patients were included in the study, comprising 18 males and 42 females.The age was (69.7±10.9)years, ranging from 45 to 91 years. Baseline clinical parameters were collected and recorded. Measurement data with normal distribution were expressed as mean ± standard deviation ( ± s), measurement data with skewed distribution were expressed as M( Q1, Q3), and count data were expressed as examples and percentages(%). Univariate Logistic regression analysis was used to screen out the risk factors related to in-hospital PE mortality, and multivariate logistic regression model was used to analyze the independent risk factors related to death of HA-PE patients. Results:Fourteen patients did not undergo surgery for primary disease due to HA-PE, the time from admission to HA-PE diagnosis was 7.0(4.0, 10.0) days. 20 patients were underwent implantation of an inferior vena cava filter, all filters used were retrievable. Successful removal of filters was achieved in 10 patients, the duration of filter placement was recorded as (19.6±3.4) days. All patients had high-risk sPESI scores, and 6 patients died from HA-PE during their hospitalization period. Multivariate analysis revealed that symptoms such as chest tightness and dyspnea ( OR=1.83, 95% CI: 1.45-10.15, P=0.039); Elevated TNI levels( OR=1.75, 95% CI: 1.46-7.78, P=0.036) and severe thrombocytopenia ( OR=3.6, 95% CI: 2.46-6.06, P=0.009) were independently correlated with in-hospital PE mortality. Conclusions:The in-hospital mortality rate of HA-PE patients is comparable to primary pulmonary embolism. Following standardized treatment, both the recurrence and mortality rates of pulmonary embolism within one year are significantly reduced. Notably, chest tightness and dyspnea, elevated TNI levels, and severe thrombocytopenia are independent risk factors for in-hospital mortality in HA-PE patients.
