Analysis Of Risk Factors And Clinical Features With Pulmonary Embolism In Middle-aged And Elderly Patients

ObjectiveBy analyzing the risk factors and clinical features of healthy people and middle-aged and elderly patients with PE,to strengthen our understanding of the elderly.MethodsUsing retrospective analysis,collecting the clinical materials of 109 patients with acute PE who were diagnosed Fujian Medical University Union Hospital from May 2017 to May 2019 and were≥40 years old,and 96 patients without PE,including the existing risk factors,clinical features,and auxiliary examinations,were analyzed and compared between the control group and patients with pulmonary embolism.SPSS 24.0 was used for statistical analysis,t test was used for measurement data,chi-square test was used for count data to analyze risk factors of PE,and statistically significant single factors were analyzed by binary logistic regression analysis.In the analysis,the bilateral p<0.05 indicated that the difference was statistically significant.Results1.Basic features:The department of respiratory medicine in the pulmonary embolism group is the most,followed by interventional department and cardiology department,accounting for 25.69,21.10%,and 9.17%,respectively,and the number of patients in each department is unevenly distributed.2.Risk factors:（1）Univariate analysis:The risk factors related to the incidence of pulmonary embolism（p<0.05）are deep vein thrombosis,smoking,surgery,tumor,bed rest,hypertension,atrial fibrillation,chronic obstructive pulmonary disease,and the remaining factors are not significantly related（p≥0.05）;（2）Multivariate logistic regression analysis:DVT,tumor,hypertension,and bed rest are independent risk factors for pulmonary embolism;（3）Establish a logistic regression equation and predict the probability of PE:The results show that the prediction accuracy of the model is 92.20%,the sensitivity is 90.82%,and the specificity is 93.75%.3.Clinical features:Divided the patients with PE in two groups,namely the middle-aged group（40-59 years old）and the elderly group（≥60 years old）.The comparison about the first symptom shows that the incidence of swelling of the lower limb in the middle-aged group was higher（p<0.05）;and the elderly group was higher in dyspnea/shortness of breath and chest tightness（all p values<0.05）.Among the two groups,there was no statistical difference between those with lung rales,pericardial effusion,and pleural effusion.4.Auxiliary examinations:In this study,most patients had different degrees of hypoxemia or respiratory failure,but compared with middle-aged groups,the elderly groups had more patients with Pa O₂ less than 80mm Hg,the difference was statistically significant（U=950.50,p=0.045）;the rest of the auxiliary examinations have no statistical significance.Conclusion1.This study found that the middle-aged group of PE had lower limb swelling/pain as the first occurrence,while the older group mostly showed chest tightness,dyspnea,and hypoxemia;2.DVT,smoking,surgery,tumor,long-term bed rest,hypertension,atrial fibrillation,COPD are associated with PE,DVT,hypertension,tumor and long-term bed rest are independent risk factors for PE.