Document Detail


Risk stratification and clinical outcomes in patients with acute pulmonary embolism.
MedLine Citation:
PMID:  21723271     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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±15years) 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 30days in patients with acute pulmonary embolism.
Authors:
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
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-24
Journal Detail:
Title:  Clinical biochemistry     Volume:  -     ISSN:  1873-2933     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0133660     Medline TA:  Clin Biochem     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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