Risk stratification and clinical outcomes in patients with acute pulmonary embolism

Chi Ming Huang, Yen Chung Lin, Yenn Jiang Lin*, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Chern En Chiang, Kang Ling Wang, Shih Ann Chen


研究成果: Article同行評審

23 引文 斯高帕斯(Scopus)


Objectives: Pulmonary embolism is a common disease associated with a high mortality rate. The risk assessment and appropriate treatment selection of patients with acute pulmonary embolism remains a challenge. Design and methods: This single center cohort study included a total of 150 patients (96 male, age = 71. ±. 15 years) with acute pulmonary embolism confirmed by spiral-computed tomography or magnetic resonance image. The prognostic performance of the clinical characteristics and laboratory values were investigated to predict the in-hospital hemodynamically instable events and 30-day all-cause mortality. Results: The rate of in-hospital hemodynamic instability and 30-day all-cause mortality was 21% and 12%, respectively. A multivariate Cox regression analysis demonstrated that a heart rate≥ 110bpm (odd ratio 4.26 [95% CI 1.42-12.77]), chronic pulmonary disease (6.47 [1.99-21.04]), WBC≥11,000mm 3 (3.78 [1.32-10.82]), and D-dimer level≥4.0μg/mL (3.68 [1.01-13.43]) independently predicted the 30-day fatal outcome. A Kaplan-Meier survival analysis showed that the categorization based on the number of risk factors was significantly associated with the likelihood of 30-day all-cause mortality (P<0.0001). Conclusions: The initial presentation of tachycardia, presence of chronic pulmonary disease, elevated WBC and D-dimer on admission can be used to identify the risk for a short-term fatal outcome within 30 days in patients with acute pulmonary embolism.

頁(從 - 到)1110-1115
期刊Clinical Biochemistry
出版狀態Published - 9月 2011


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