In-hospital and short-term predictors of mortality in patients with intermediate-high risk pulmonary embolism

• Published in: Journal of cardiovascular and thoracic research 2020-01, Vol.12 (4), p.321-327
• Main Authors: Gök, Gulay, Karadağ, Mehmet, Çinar, Tufan, Nurkalem, Zekeriya, Duman, Dursun
• Format: Article
• Language: English
• Subjects: acute pulmonary embolism; Biomarkers; Blood pressure; Cardiac arrhythmia; Cardiovascular disease; Dementia; Heart failure; Hospitals; Hypotension; intermediate-high risk; Laboratories; Medical imaging; Medical records; Mortality; Normal distribution; Original; Patients; Pulmonary arteries; Pulmonary embolisms; Statistical analysis
• ISSN: 2008-5117; 2008-6830
• DOI: 10.34172/JCVTR.2020.51

The aim of this study was to evaluate the in-hospital and short-term predictive factors of mortality in intermediate-high risk acute pulmonary embolism (PE) patients with right ventricle (RV)dysfunction and myocardial injury. In this retrospective study, the medical records of 187 patients with a diagnosis of intermediate high risk acute PE were evaluated. A contrast-enhanced multi-detector pulmonary angiography was used to confirm diagnosis in all cases. All-cause mortality was determined by obtaining both in hospital and 30 days follow-up data of patients from medical records. During the in-hospital stay (9.5±4.72 days), 7 patients died, resulting in an acute PE related in-hospital mortality of 3.2%. Admission heart rate (HR), (Odds ratio (OR), 1.028 95% Confidence interval (CI), 0.002-1.121; = 0.048) and blood urea nitrogen (BUN) (OR, 1.028 95% CI, 0.002-1.016; = 0.044) were found to be independent predictors for in-hospital mortality in a multi variate logistic regression analysis. In total, 32 patients (20.9%) died during 30 days follow-up.The presence of congestive heart failure (OR, 0.015, 95%CI, 0.001-0.211; = 0.002) and dementia (OR, 0.029, 95%CI,0.002-0.516; = 0.016) as well as low albumin level (OR, 0.049 95%CI, 0.006-0.383; = 0.049) were associated with 30 days mortality. HR and BUN were independent predictors of in-hospital mortality and the presence of congestive heart failure, dementia, and low albumin levels were associated with higher 30 days mortality.