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Pulmonary Embolism: Treatment Outcomes and Prognostic Factors of Mortality in University Hospital

Juthamas Inchai PhD¹ , ³, Chaicharn Pothirat MD¹, Chalerm Liwsrisakun MD¹, Juntima Euathrongchit MD², Pattraporn Tajareunmuang MD¹, Kittipan Rerkasem MD, PhD³ , ⁴

Affiliation : ¹ Division of Pulmonary, Critical Care and Allergy, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ² Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ³ NCD Center, Research Institute of Health Science, Chiang Mai University, Chiang Mai, Thailand ⁴ Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand


Objective : To determine the treatment outcomes, and to identify the prognostic factors of hospital mortality of pulmonary embolism (PE) patients.
Materials and Methods : A retrospective cohort study was conducted in a 1,400-bed university hospital. Demographic, Medical history, clinical data and treatment outcomes were collected. Logistic regression was performed to identify prognostic factors for all-cause of hospital mortality.
Results : One hundred fifty-eight patients with PE were included, 47.5% were male and the mean age was 59.2±14.7 years. The most common of clinical presentation are dyspnea 125 (79.1%), tachycardia 72 (45.6%), and hypotension 39 (24.7%). Forty patients (25.3%) had acute massive PE. The overall mortality rate (MR) was 19.6% and intensive care unit (ICU) MR was found in 34.5%. The prognostic factors of mortality were massive PE (adjusted odds ratio [AOR] 5.44, 95% confidence interval [CI] 1.10 to 27.06, p=0.039), cancer (AOR 4.45, 95% CI 1.52 to 12.98, p=0.006), respiratory failure (AOR 3.63, 95% CI 1.10 to 12.10, p=0.019), and SOFA score of 5 or greater (AOR 3.46, 95% CI 1.11 to 10.80, p=0.032).
Conclusion : PE is associated with high mortality in hospital, especially in ICU. The prognostic factors for hospital mortality were massive PE, respiratory failure, cancer comorbidity and SOFA score of 5 or greater.

Received 17 June 2020 | Revised 14 October 2020 | Accepted 15 October 2020
doi.org/10.35755/jmedassocthai.2021.02.11545

Keywords : Pulmonary embolism, Prognostic factor, Mortality, Treatment outcomes


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