Prognostic value of laboratory markers in patients with acute pulmonary embolism

Abstract

Background Acute pulmonary embolism (APE) is a serious illness. Identifying prognostic factors for APE may help in the management of those patients. This study's objective was to evaluate the prognostic value of laboratory markers in predicting right ventricular dysfunction (RVD) and 30-day mortality in pulmonary embolism patients. Methods Eighty patients with APE were enrolled and followed up for 30-day. Detailed echocardiography was done to evaluate RVD. All patients were subjected to arterial blood gas analysis, complete blood count (CBC), plasma concentration of C-reactive protein (CRP), serum D-dimer level, and serum troponin I level, and the following ratio were calculated: Neutrophil to lymphocytic ratio (NLR), Platelet to lymphocytic ratio (PLR), Red cell distribution width (RDW), Mean platelet volume (MPV) and alveolar to arterial gradient. Results Our results analysis revealed significantly elevated levels of median NLR, PLR, CRP, D-dimer, and troponin in both the RVD and non-survivor groups (P value < 0.001). The blood markers that showed the highest predictive ability for right ventricular dysfunction (RVD) and 30-day mortality, as determined by receiver operating characteristic (ROC) analysis and logistic regression, were A-a O2 gradient, serum troponin, CRP, D-dimer, NLR, and PLR (P value < 0.001). Conclusion Evaluation of different serum markers including NLR, PLR, RDW, CRP, D-dimer, troponin and A-a O₂ gradient are simple and available markers for predicting right ventricular dysfunction (RVD) and 30- day mortality in patients with APE. Trial registration: ClinicalTrials.gov ID: NCT04237974.