Predictors of Mortality in Pulmonary Embolism: A Real-Life Study

Füsun Fakılı; Mahşuk Taylan; İrem Zehra Bilgiç; İrfan Veysel Düzen

doi:10.58600/eurjther1818

Authors

Füsun Fakılı Department of Pulmonary Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey https://orcid.org/0000-0002-1602-5240
Mahşuk Taylan Department of Pulmonary Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey. https://orcid.org/0000-0003-4072-2270
İrem Zehra Bilgiç Department of Pulmonary Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey. https://orcid.org/0009-0008-8432-5617
İrfan Veysel Düzen Department of Cardiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey https://orcid.org/0000-0003-2312-4252

DOI:

https://doi.org/10.58600/eurjther1818

Keywords:

pulmonary embolism, Mortality, Risk Factors, Prognosis

Abstract

Objective: The primary aim of this study was to investigate the mortality and associated factors in patients with pulmonary embolism.

Methods: A retrospective analysis was performed on adult patients with pulmonary embolism who applied to X University Hospital between January 1, 2017, and January 1, 2023. All-cause mortality and related factors in pulmonary embolism patients were determined.

Results: This study included 152 patients with a median age of 59 years and 81 (53.3%) women. The all-cause mortality rate was 25.7%, and pulmonary embolism-related deaths were 1.3%. Age (p<0.001), chronic obstructive pulmonary disease (COPD) (p=0.013), heart failure (p=0.018), atrial fibrillation (p=0.015), massive pulmonary embolism (p=0.029), hemoglobin level (p<0.001) and NT-Pro BNP level (p<0.001) were significantly associated with increased all-cause mortality. In binary logistic regression analysis, for each unit of increasing pulmonary embolism severity index (PESI) score, mortality increased 2.2-fold (95% CI:1.03-5.09), massive PTE 1.6-fold (95% CI:0.14-17.86), anticoagulant duration (daily) 0.98-fold (95% CI:0.98-0.99) and Hb level (per unit Hb reduction) 0.67-fold (95% CI:0.45-1.02) mortality was increasing. There was no statistical difference between the number of hospitalization days for patients with low and high PESI and simplified PE severity index (sPESI) scores.

Conclusions: All-cause mortality in patients with pulmonary embolism increased with age, cardiac diseases, and COPD comorbidities. The PESI and sPESI scores used in the acute phase of PTE were found to be highly reliable in predicting all-cause mortality in PE patients. The diagnosis of massive PE and elevated NT-proBNP levels, a marker of right ventricular dysfunction, were factors that increased mortality.

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References

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