Characteristics and Mortality in High-, Intermediate-, and Low-Risk Acute Pulmonary Embolism Patients in the Emergency Department
Ienghong K, MD1, Kulsutcharit K, MD1, Apiratwarakul K, MD1, Gaysonsiri D, MD1, Mitsungnern T, MD1, Bhudhisawasdi V, MD1
Affiliation : 1 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Acute pulmonary embolism (APE) is a life-threatening condition. However, most APE patients have non-specific
signs and symptoms. In 2019, the European Society of Cardiology published guidelines classifying the severity of APE, but no study
has yet been conducted in the Thai population based on those guidelines.
Objective : To study characteristics and mortality in hospital, at 30 days, and at 1 year in APE patients classified by disease severity.
Materials and Methods : This was a retrospective descriptive study. The population consisted of patients diagnosed with acute
pulmonary embolism at the emergency department of Khon Kaen University’s Srinagarind Hospital from January 1, 2008 to
November 30, 2018. Data were collected by reviewing hospital information program, medical charts, and PACS. Statistical analysis
was performed using a Fisher’s exact test to study the characteristics of patients and the death rate among these patients.
Results : A total of 110 patients had confirmed diagnoses of APE, 60.91% who were female. In terms of risk level, 2.72%, 35.45%, and
3.63% of patients were high-, intermediate-, and low-risk, respectively. Immobilization was significantly associated with high- and
intermediate-risk, and high-sensitivity cardiac troponin t-test (hs-cTnT), N-terminal pro b-type natriuretic peptide (NTproBNP)
levels, and RV dilatation were significantly associated with disease severity. Most patients received medical treatment. Mortality in
hospital, at 30 days, and at 1 year was 9.09%, 11.81%, and 31.81%, respectively.
Conclusion : Some patient characteristics were associated with the disease severity. The mortality rate was high in the intermediate-
risk group. This differed from the results of other studies, which found higher mortality rates in high-risk patients. Due to the small
population in this study (especially high-risk patients) further research is necessary.
Keywords : Acute pulmonary embolism, ESC PE guideline 2019, Emergency department
