Investigation On The Related Situation Of Sudden Pulmonary Thromboembolism In Hospital

Objective:Pulmonary thromboembolism(PTE)is mainly a manifestation of pulmonary circulation and respiratory dysfunction,and is a common cardiovascular disease that seriously threatens national health.Although in recent years China has issued relevant guidelines on prevention,diagnosis and treatment of PTE,PTE still has the characteristics of low prevention rate,high rate of missed diagnosis,high incidence rate and high mortality.The exact epidemiological data of PTE is still lacking in China,but the prevalence of PTE in hospitalized patients has increased from 1997 to 2008(from 0.03% to 0.14%).Sudden pulmonary thromboembolism in hospitalized patients has become The common complications are serious problems that hospital doctors and hospital administrators need to face,causing serious economic and mental burden to patients and their families.Due to the occurrence of pulmonary thromboembolism and patients’ own factors,surgical trauma factors,internal medicine Disease factors and treatment measures are related,so it involves many clinical departments.Therefore,it is especially important to improve the prevention and control awareness of medical staff in the hospital and to carry out multi-disciplinary prevention and treatment of pulmonary thromboembolism in hospitals.This study retrospectively analyzes the clinical data of patients with sudden pulmonary thromboembolism during hospitalization in our hospital.The purpose of this study is to understand the risk factors,departmental distribution,critical condition,and deep vein thrombosis in patients with sudden pulmonary thromboembolism in our hospital.Etc.and try to select a more concise and effective clinical likelihood assessment scale for inpatients to explore whether the diagnosis of pulmonary thromboembolism can be further simplified.Method:1.This subject is a retrospective study,collected from January 2008 toJanuary 2018 in Chengde Medical College Affiliated Hospital during hospitalization of 111 patients with sudden PTE clinical data,including gender,age,admitted department and disease,admission diagnosis,surgery,pulmonary embolism prevention,initial symptoms,combined with deep vein thrombosis,treatment and outcomes.2.To compare the risk stratification of pulmonary thromboembolism between patients with internal medicine and surgical inpatients,the simple combination of muscular venous thrombosis and the combination of non-muscular venous thrombosis,and to explore the factors influencing the severity of pulmonary thromboembolism in hospital.3.Wells scale and revised Geneva scale were used to evaluate the clinical possibility of pulmonary thromboembolism when suspected of pulmonary thromboembolism.The consistency of the two scales was compared.4.Risk assessment of pulmonary thromboembolism was performed on all patients at admission.The Department of Internal Medicine used the Padua rating scale and the surgical use of the Caprini risk assessment scale;the Wells scale,the revised Geneva scale and the Padua score scale,and the Caprini risk assessment were performed.Consistency analysis between the scales explores the possibility of applying a PTE risk score instead of a PTE clinical likelihood score.5.Statistical methodsSPSS19.0 software package was used for statistical analysis.Contingency table analysis and chi-square test were used for counting data.Karppa test was used for consistency analysis among various scales,with P < 0.05 as the difference with statistical significance.Result:1.General and clinical data of patientsA total of 111 patients in this group,mainly distributed in geriatrics(17.1%),oncology(11.7%),orthopedics(14.4%),respiratory(6.3%);high-risk pulmonary embolism accounted for up to 43.2%;and other Compared with the age group,patients in the 60-79 age group accounted for a large proportion,p<0.05,and the difference was statistically significant.2.Risk stratification of sudden PTE in hospitalized patients Compared with hospitalized patients,the difference was not statistically significant.There was no significant difference between the patients with simple myometrial thrombosis and those with non-intermuscular thrombosis.p>0.05,the difference was not statistically significant.3.Consistency between3.Consistency Analysis of Wells Scale and Modified Geneva Scale Evaluation Results The overall agreement rate of the Wells scale and the revised Geneva scale was 83.8%,Kappa=0.297,and the consistency was poor.4.Consistency Analysis of Wells Scale,Modified Geneva Scale and Padua Rating Scale,and Caprini Risk Assessment ScaleThe overall agreement rate of the wells scale and the padua scale was 55%,Kappa=0.133,and the consistency was poor.The overall agreement rate of the Wells scale and the Caprini scale was 29.4%,Kappa=0.022,and the consistency was poor;the Geneva scale was revised and The overall agreement rate of the padua scale was 43.3%,Kappa=-0.067,and the consistency was poor.The overall agreement rate of the modified Geneva scale and the Caprini scale was 23.5%,Kappa=0.031,and the consistency was poor.Conclusion:1.Patients with sudden PTE during hospitalization were mostly elderly with 60-79 years old;high-risk PTE was high;oncology,orthopedics,and respiratory departments may be high-risk departments of PTE.2.There is a risk stratification of pulmonary thromboembolism between patients with medical and surgical inpatients,between patients with simple intermuscular veins and with non-intermuscular vein thrombosis,that is,there is no difference in the severity of the disease,indicating that all departments need to Equal attention is paid to the prevention of PTE,and the importance of intermuscular venous thrombosis should be increased.3.For hospitalized patients,the consistency of the PTE clinical likelihood assessment using the Wells Scale and the Modified Geneva Scale is poor,suggesting that clinicians may need to be more cautious in assessing the selection and application of the scale.4.The consistency between the PTE risk assessment scale and the clinical likelihood assessment scale is poor,indicating that for hospitalized patients,the risk assessment scale cannot be simply used instead of the clinical likelihood assessment scale.