Clinical Characteristics And Prognosis Of Patients With Acute Pulmonary Thromboembolism With Different Body Mass Index

【Objective】To discuss the influence of different body mass index(BMI)on the clinical medical characteristics and living conditions of patients with acute pulmonary thromboembolism,PTE),so as to provide reasonable intervention and treatment for PTE patients with different BMI.【Methods】Retrospective analysis of hospitalized patients who met the diagnosis of PTE in the Hospital of Yunnan University from June 2020 to June 2022.According to BMI,the patients were divided into three groups : normal weight group(24.0kg / m2 >BMI ≥ 18.5kg / m2),overweight group(24.0kg / m2 ≤ BMI < 28 kg / m2)and obese group(BMI ≥ 28 kg / m2).The general situation,clinical data,treatment and prognosis of the three groups of patients were statistically analyzed,and the differences between the clinical characteristics and prognosis of the three groups of PTE patients with different BMI were analyzed and compared.Logistic regression model was used to analyze the prognostic factors of PTE.【Results】1.A total of 488 patients with PTE were included.There were 245 cases of normal weight group,including 133 males and 112 females,aged from 19 to 92 years old,with an average of 66 ± 16 years old.There were 178 cases of overweight,including 110 males and 68 females,aged 21-92 years,with an average age of 62 ± 15 years.There were 65 cases in the obese group,including 30 males and 35 females,aged 25-91 years,with an average age of 64 ± 15 years.There was no significant difference in sex ratio,average age,smoking rate and clinical symptoms related to pulmonary embolism among the three groups(all P > 0.05).2.The proportion of PTE patients in the obese group than recombinant PTE patients was statistically significant(all P <0.0167).In the obese group,the higher proportion of PTE patients with diabetes,cerebrovascular disease and hyperlipidemia than those with normotensive recombinant PTE,which was statistically significant(all P <0.0167).In the obese group,hematocrit,hemoglobin,triglyceride,and uric acid levels were higher than normal subjects,statistically significant(all P <0.0167);in overweight subjects,leukocytes were higher than normal levels,statistically significant(all P <0.0167).3.In the obese group,hematocrit,hemoglobin,triglyceride,and uric acid levels were higher than those in normal subjects(all P <0.0167)and in patients with super PTE than those with normal PTE(all P <0.0167).4.The proportion of pleural effusion was higher in patients with hyperrecombinant PTE(P <0.0167).5.More obese patients with PTE than normal and overweight PTE were statistically significant(P values <0.001 and <0.001,respectively);obese and overweight recombinant PTE(P values <0.001 and <0.001);PTE than normal PTE(P values <0.001,<0.001,respectively).6.The high-risk grade and hospitalization mortality of patients with hyperrecombinant PTE were lower than those with normal recombinant PTE(all P<0.0167).7.The proportion of PTE patients in the supergroup was higher than that in normal group,and more in the obese group,with a statistically significant difference(all P <0.0167).8.Multivariate logistic regression analysis showed that: diabetes mellitus(OR =8.755,95%CI:1.422～ 53.9,P=0.019),pneumonia(OR = 24.88,95%CI:1.6～ 385.629,P=0.022),high-risk PTE(OR = 115.334,95%CI:6.145～2164.759,P=0.002)was a predictor of PTE death,While BMI 28 kg/m2(OR = 0.019,95%CI:0～ 0.966,P=0.048)was a predictor of PTE survival.【Conclusion】:1.Three groups of PTE patients with different BMI differ in comorbidities,clinical biochemical parameters,echocardiography,treatment,and prognosis.2.In clinical practice,more attention should be paid to the treatment of hypertension,diabetes,cerebrovascular disease,hyperlipidemia and other complications in obese PTE patients.Appropriate lipid-lowering and uric acid lowering treatment can be given to obese PTE patients,and more attention should be paid to the changes of right heart function of obese PTE patients.3.Oral DOCAs can be given as the preferred anticoagulant,which has a better prognosis than normal weight patients,and BMI 28 kg/m2 is a predictor of survival in PTE patients.