| Objectives:To explore the clinical features and prognosis of pulmonary embolism in the elderly,and the value of PESI and sPESI scores in the diagnosis of pulmonary embolism in the elderly.Methods:1.By using case-control method and retrospective analysis to study on patients who have been definitely diagnosed in our hospital and underwent pulmonary CT angiography(CTPA)and/or pulmonary perfusion imaging diagnosis on August 1,2017 to August 31,2018.Of which 121 cases of elderly(>50 years old)patients with pulmonary embolism were selected as a case group(Group 1),and non-elderly(≤50)patients were randomly selected as control group who were hospitalized during the same period.2.The age,gender,pulse,systolic blood pressure,respiratory frequency,body temperature,arterial oxygen saturation,whether the patient is complicated with tumor,whether there is chronic cardiopulmonary disease,whether there is mental state change,delay in medical treatment and other basic information of the patient were collected.Typical symptoms of pulmonary embolism,such as dyspnea,chest pain,hemoptysis,cough,syncope and nervous tension were collected.BNP,NT-proBNP/d-dimer results were collected.Histories of common risk factors for pulmonary embolism such as deep venous thrombosis(DVT)in the lower extremities was collected.Analyze the clinical characteristics and prognostic risk factors of elderly patients with pulmonary embolism.3.Calculate and collect the PESI(sPESI)scores of patients in the pulmonary embolism group and the non-pulmonary embolism group,compare the differences between the two groups,and analyze the application value of PESI(sPESI)score in evaluating the prognosis of elderly patients with pulmonary embolism.Results:1.The most common clinical symptoms in both groups were dyspnea and chest pain.Palpitations,syncope and hemoptysis were followed by the elderly group,and syncope,palpitations and hemoptysis were followed by the non-elderly group.There was no significant difference in symptoms and signs between the two groups.2.Compared with the non-elderly group,the elderly group had a higher proportion of patients with hypertension(P < 0.05),and the history of DVT was the most common risk factor,while the history of DVT in the elderly group was significantly lower than that in the non-elderly group(P < 0.05).There was no significant difference between the two groups in other common risk factors such as tumor history,chronic lung disease,recent history of braking,and diabetes.3.BNP was higher in the elderly group(P<0.05),and there was no significant difference in cTnI,d-dimer and inflammatory index groups.In the elderly group,HDL was often increased(P < 0.05),urea nitrogen and creatinine were increased(P < 0.05),and there was no significant difference in other dyslipidemia and renal function.4.The PESI score of the elderly group was significantly higher than that of the non-elderly group(P < 0.05),the proportion of pesi-5 in the elderly group was greater than that of the non-elderly group,and the proportion of pesi-1 was smaller than that of the non-elderly group(P < 0.05).There was no significant difference in treatment,risk stratification and clinical adverse events between the two groups.5.The PESI score of the elderly group was significantly higher than that of the non-elderly group,and there was no significant difference in sPESI score between the two groups.There was no significant correlation between PESI score and middle risk stratification of sPESI in the elderly group and the incidence of clinical adverse events(P > 0.05).PESI score and middle risk stratification of sPESI in non-elderly groups were significantly correlated with the incidence of clinical adverse events(P < 0.05).1.Elderly patients with pulmonary embolism,female,BNP/ nt-probnp and d-dimer increase is important for the diagnosis of the disease;Conclusions:1.Elderly patients with pulmonary embolism are more likely to have a history of hypertension.2.Elderly patients with pulmonary embolism are more likely to have abnormal cardiac function and renal function.3.The previous history of DVT in the non-elderly group was significantly higher than that in the elderly group.4.According to the prognosis of non-elderly patients with pulmonary embolism,PESI score and sPESI score were significant. |
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