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Submitted: 29 Jul 2020
Revision: 13 Nov 2020
Accepted: 13 Nov 2020
ePublished: 28 Nov 2020
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J Cardiovasc Thorac Res. 2020;12(4): 321-327.
doi: 10.34172/jcvtr.2020.51
PMID: 33510882
PMCID: PMC7828758
Scopus ID: 85107902490
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    • Citation Indexes: 11
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    • Readers: 14
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Original Article

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

Gulay Gök 1 ORCID logo, Mehmet Karadağ 2, Tufan Çinar 3* ORCID logo, Zekeriya Nurkalem 1, Dursun Duman 1

1 Medipol University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
2 Hatay Mustafa Kemal University Faculty of Medicine, Department of Biostatistics, Hatay, Turkey
3 Health Sciences University, Sultan 2. Abdülhamid Han Training and Research Hospital, Department of Cardiology, İstanbul, Turkey
*Corresponding Author: Email: drtufancinar@gmail.com

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: In this retrospective study, the medical records of 187 patients with a diagnosis of intermediate high 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 multi variate 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 congestive heart failure, dementia, and low albumin levels were associated with higher 30 days mortality.
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