Acute Pulmonary Embolism: Clinical Characteristics and Outcomes in a University Teaching Hospital

Jin Nyeong Chae; Won-Il Choi; Jie Hae Park; Byung Hak Rho; Jae Bum Kim

doi:10.4046/trd.2010.68.3.140

Journal List > Tuberc Respir Dis > v.68(3) > 1001479

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Chae, Choi, Park, Rho, and Kim: Acute Pulmonary Embolism: Clinical Characteristics and Outcomes in a University Teaching Hospital

Original Article

Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(3): 140-145.

Published online: 31 March 2010

DOI: https://doi.org/10.4046/trd.2010.68.3.140

Acute Pulmonary Embolism: Clinical Characteristics and Outcomes in a University Teaching Hospital

Jin Nyeong Chae, M.D.¹, Won-Il Choi, M.D.¹, Jie Hae Park, M.D.¹, Byung Hak Rho, M.D.², Jae Bum Kim, M.D.³

¹Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.

²Department of Diagnostic Radiology, Keimyung University School of Medicine, Daegu, Korea.

³Department of Thoracic Surgery, Keimyung University School of Medicine, Daegu, Korea.

Address for correspondence: Won-Il Choi, M.D. Department of Internal Medicine, Keimyung University School of Medicine, 216, Dalseong-ro, Jung-gu, Daegu 700-712, Korea. Phone: 82-53-250-7572, Fax: 82-53-250-7434, wichoi@dsmc.or.kr

Received 24 November 2009 Accepted 29 December 2009

Abstract

Background

Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced.

Methods

We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis.

Results

The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%).

Conclusion

PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.

Keywords: Pulmonary Embolism, Venous Thrombosis, Prognosis, Risk Factors, Thrombophilia

Figures and Tables

Figure 1

Distribution of disease by age and sex in 105 patients with acute pulmonary thromboembolism.

Figure 2

All-cause cumulative mortality.

Table 1

Risk factors

BMI: body mass index.

Table 2

Baseline clinical characteristics

Table 3

The number of risk factors in patients with multiple risk factors

Table 4

Thrombus site in CTPA

CTPA: computed tomographic pulmonary angiography.

Table 5

Factors associated with death in patients with pulmonary embolism by multiple logistic regression analysis

B: regression coefficient; S.E.: standard error; Sig.: significance; OR: odds ratio; CI: confidence interval; BMI: body mass index.

Table 6

Summary of protein C and protein S deficiency

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