Predictors of Short-Term Mortality in Patients with Acute Pulmonary Embolism

Abdelfattah, Rasha A.; Mohamed, Ahmed H.; Ali, Yosra M.; Abdel Aziz, Mohammad O.; Abdullah, Noha M.; Asklany, Hany T.; Mohammed, Saleh A.; Higazi, Mahmoud M.; Abdelaziz, Ali O.

doi:10.21608/ejhm.2022.254833

Predictors of Short-Term Mortality in Patients with Acute Pulmonary Embolism

Document Type : Original Article

Authors

10.21608/ejhm.2022.254833

Abstract

Background: Pulmonary embolism (PE) is associated with short- and long-term adverse events including mortality. Prompt diagnosis, risk stratification and treatment can improve the outcome. The objective of the present study is to determine the predictors of early death within 30 days in the course of acute pulmonary embolism (APE). Patients and methods: One hundred patients with APE were recruited from both inpatients department and ICUs at Cardiothoracic Minia University Hospital .All patients subjected to detailed history, general and local chest examination. Laboratory investigation included CBC, Hs-CRP, troponin and D-dimer. CT pulmonary angiogram (CTPA) with calculation of pulmonary artery obstructive index (PAOI) using Qandali Score and measurement of right ventricle to left ventricle (RV/LV) ratio, Echo with measurement of pulmonary artery systolic pressure (PASP) were done for all patients. Patients were monitored for 30 days from the onset of symptoms to assess the mortality. Results: Patients classified according to outcome into survivors, 80 (80%) patients and 20 (20%) non-survivors patients. Po2 and Sao2 were significantly higher in survivors (P values 0.0001 and 0.05, respectively). Pulmonary Embolism Severity Index (PESI) was significantly higher in the non-survivor group(P value 0.001). PAOI and RV/LV ratio were higher in non survivors with (P value 0.001 and 0.001, respectively). Also central location of emboli was higher in non survivors representing. PASP was higher in non survivors (P value 0.001). Conclusion: The non-survivor group showed decrease Po2 and Sao2, higher PESI, PAOI, RV/LV ratio, and dilated RV compared with the survivor group. Thus these parameters could be predictors for poor patient outcome.

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