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Abstract：
BACKGROUND: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand.
METHODS: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded.
RESULTS: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84).
CONCLUSIONS: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.
METHODS: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded.
RESULTS: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84).
CONCLUSIONS: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.
摘要：
背景：急性肺栓塞（APE）是一种具有不同临床特征和影像学表现的致命性疾病。这项研究的目的是确定临床特征，危险因素，以及泰国一所大学医院的APE患者的结局。
方法：回顾性纳入2017年1月1日至2022年12月31日被诊断为APE并入院的患者。临床特点,调查,并记录结果。
结果：在6年的研究期间，369例患者诊断为APE。平均年龄为65岁；64.2%为女性。APE最常见的危险因素是恶性肿瘤(46.1%)。住院死亡率为23.6%。计算机断层扫描肺动脉显示最近端的血凝块主要在节段性肺动脉（39.0％），其次是主肺动脉(36.3%)。这种分布在幸存者和非幸存者之间是一致的。多因素logistic回归分析显示，APE死亡率与活动性恶性肿瘤相关，血清肌酐升高，较低的体重指数（BMI），和心动过速的调整比值比（95％置信区间[CI]）为3.70（1.59至8.58），3.54（1.35至9.25），2.91（1.26至6.75），和2.54（1.14至5.64），分别。构建预测模型,曲线下面积为0.77(95%CI,0.70~0.84)。
结论：APE患者的总死亡率为23.6％，APE相关死亡占5.1%。APE死亡率与活动性恶性肿瘤相关，血清肌酐升高，较低的BMI,和心动过速.
方法：回顾性纳入2017年1月1日至2022年12月31日被诊断为APE并入院的患者。临床特点,调查,并记录结果。
结果：在6年的研究期间，369例患者诊断为APE。平均年龄为65岁；64.2%为女性。APE最常见的危险因素是恶性肿瘤(46.1%)。住院死亡率为23.6%。计算机断层扫描肺动脉显示最近端的血凝块主要在节段性肺动脉（39.0％），其次是主肺动脉(36.3%)。这种分布在幸存者和非幸存者之间是一致的。多因素logistic回归分析显示，APE死亡率与活动性恶性肿瘤相关，血清肌酐升高，较低的体重指数（BMI），和心动过速的调整比值比（95％置信区间[CI]）为3.70（1.59至8.58），3.54（1.35至9.25），2.91（1.26至6.75），和2.54（1.14至5.64），分别。构建预测模型,曲线下面积为0.77(95%CI,0.70~0.84)。
结论：APE患者的总死亡率为23.6％，APE相关死亡占5.1%。APE死亡率与活动性恶性肿瘤相关，血清肌酐升高，较低的BMI,和心动过速.
