In-hospital and short-term predictors of mortality in patients with intermediate-high risk pulmonary embolism

Abstract

Introduction:The aim of this study was to evaluate the in-hospital and short-term predictive factors of mortality in intermediate-high risk acute pulmonary embolism (PE) patients with right ventricle (RV) dysfunction and myocardial injury. Methods:Inthisretrospectivestudy,themedicalrecordsof187patientswithadiagnosisofintermediatehigh risk acute PE were evaluated. A contrast-enhanced multi-detector pulmonary angiography was used to confirm diagnosis in all cases. All-cause mortality was determined by obtaining both in-hospital and 30 days follow-up data of patients from medical records. Results: During the in-hospital stay (9.5±4.72 days), 7 patients died, resulting in an acute PE related in-hospital mortality of 3.2%. Admission heart rate (HR), (Odds ratio (OR), 1.028 95% Confidence interval (CI), 0.002-1.121; P=0.048) and blood urea nitrogen (BUN) (OR, 1.028 95% CI, 0.002-1.016; P=0.044) were found to be independent predictors for in-hospital mortality in a multivariate logistic regression analysis. In total, 32 patients (20.9%) died during 30 days follow-up.The presence of congestive heart failure (OR, 0.015, 95%CI, 0.001-0.211; P=0.002) and dementia (OR, 0.029, 95%CI, 0.002-0.516; P=0.016) as well as low albumin level (OR, 0.049 95%CI, 0.006-0.383; P=0.049) were associated with 30 days mortality. Conclusion: HR and BUN were independent predictors of in-hospital mortality and the presence of congestiveheartfailure,dementia,andlowalbuminlevelswereassociatedwithhigher30daysmortality.