Identification of Prognostic Factors for Recurrence and Mortality in Patients With Acute Pulmonary Embolism

Abstract

Background: This study aimed to explore prognostic factors for 1-year recurrence and mortality in patients with acute pulmonary embolism (APE). Methods: APE patients who attended the Emergency Department of Fujian Provincial Hospital from January 2016 to June 2020 were recruited. Univariate and multivariate logistic regression analyses were carried out to determine the prognostic factors for 1-year recurrence and mortality. Results: A total of 458 APE patients were included, of whom 81 (17.69%) had recurrence, and 97 (21.18%) died. Multivariate logistic regression analyses revealed that smoke (OR: 1.949; 95% CI: 1.094–3.470; P = 0.023), abnormal platelet distribution width (OR: 3.013; 95% CI: 1.574–5.767; P = 0.001), and interrupted maintenance therapy (OR: 18.280; 95% CI: 9.777–34.179; P < 0.001) were significantly associated with an increased risk of 1-year recurrence in APE patients. Age ≥65 years (OR: 3.492; 95% CI: 1.876–6.500; P < 0.001), history of malignancy (OR: 7.190; 95% CI: 3.804–13.587; P < 0.001), history of long-term immobilization (OR: 6.244; 95% CI: 3.472–11.228; P < 0.001), mechanical ventilation (OR: 5.971; 95% CI: 3.154–11.304; P < 0.001), and interrupted maintenance therapy (OR: 2.414; 95% CI: 1.315–4.432; P = 0.004) were independent prognostic factors for 1-year mortality. The AUC of 1-year mortality and recurrence prediction models were 0.852 (95% CI: 0.805–0.898) and 0.868 (95%CI: 0.832–0.905). Conclusion: In patients with APE, history of smoking, abnormal PDW, and interrupted maintenance therapy were significantly associated with the risk of 1-year recurrence, while age ≥65 years, history of malignancy, history of long-term immobilization, mechanical ventilation, and interrupted maintenance therapy were independent prognostic factors for 1-year mortality.