Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Clinical Characteristics, Risk Factors, and Outcomes of Acute Pulmonary Embolism in Thailand: 6-Year Retrospective Study

  • Pattarin Pirompanich (Division of Pulmonology and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Thammasat University) ;
  • Ornnicha Sathitakorn (Division of Hematology, Department of Medicine, Faculty of Medicine, Thammasat University) ;
  • Teeraphan Suppakomonnun (Department of Medicine, Faculty of Medicine, Thammasat University) ;
  • Tunlanut Sapankaew (Department of Medicine, Faculty of Medicine, Thammasat University)
  • Received : 2023.08.02
  • Accepted : 2024.02.27
  • Published : 2024.07.31
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Abstract

Background: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand. Methods: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded. Results: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84). Conclusion: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.

Keywords

Acknowledgement

The authors would like to express our gratitude to Thammasat University Hospital for providing the patient data and to Sam Ormond for reviewing the English language use in our manuscript.

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