Abstract
Background: Pulmonary embolism (PE) is a severe medical condition characterized by the occlusion of pulmonary blood vessels by a thrombus. This study aimed to offer a comprehensive understanding of the demographic characteristics, risk factors, and clinical manifestations of hospitalized patients with PE, as well as evaluate their short- to mid-term prognoses.
Methods: A total of 109 adult patients with a primary diagnosis of PE, admitted between 2018 and 2020, were included in the study.
Results: The patient cohort had a mean age of 59 years, with males accounting for 51.4% of the participants. The most prevalent symptom reported by patients was dyspnea, followed by chest pain. Pulmonary CT angiography was the primary diagnostic modality employed. Sub-massive PE constituted the most frequent subtype, with 61.5% of cases being provoked by embolisms. The majority of patients exhibited abnormal electrocardiogram (ECG) findings. Elevated levels of D-dimer and troponin were observed in the study population. In-hospital mortality was recorded at 10%, with several factors associated with increased mortality rates, including female gender (p = 0.029), provoked PE (p = 0.006), absence of thrombolytic therapy (p = 0.001), and left ventricular ejection fraction (LVEF) below 50% (p = 0.001). During the mid-term follow-up, the mortality rate rose to 22.8%, with advanced age emerging as a significant risk factor (p = 0.002). Thrombolytic therapy (p = 0.65), LVEF (p = 0.37), and pulmonary artery pressure (p = 0.33) did not exert a significant impact on mid-term mortality. The majority of patients were discharged with warfarin or novel oral anticoagulant (NOAC) therapy, and some exhibited impaired right ventricular function.
Conclusion: This study demonstrates that the absence of thrombolytic therapy in patients with massive embolism, along with the presence of risk factors such as immobility, malignancy, age over 65 years, and female gender, are significantly associated with short- and mid-term mortality in patients with pulmonary embolism.