Study Of Risk Factors And Clinical Features Of Patients With Pulmonary Thromboembolism In The Elderly

Objective To analyze the risk factors and clinical features of the elderly pulmonary thromboembolism (PTE) patients in comparison to the younger patients.Methods 362 patients with PTE were enrolled in the retrospective study, which included 184 elderly patients (≥60 ages) and 178 non-elderly patients (<60 ages). Risk factors, clinical features, diagnostic methods and treatment were analyzed.Results①The age span of PTE incidence in the elderly group concentrated on 60-69(26.24%), the age span of≥70 (24.59%) and 50-59 (20.17%) followed.②The older group was always accompanied by various fundamental diseases, in which heart and lung diseases were common. The independent dangerous factors in elderly PTE group included malignancy, coronary heart disease and chronic obstructive pulmonary disease (OR=235.229, 43.232, 5.774;P=0.001, 0.005, 0.009 respectively), while the youger group's was operation (OR=0.028, P=0.002).③The incidence of thoracalgia, hemoptysis and triad of older group were lower than the youger's (P<0.05). Dyspnea was the commonly clinical symptom in both groups (73.91%, 73.03%). The incidence of cyanosis in older group (13.59%)was higher than in the youger's (2.25%) (P<0.05).④The positive rate of D-dimer of the older group with PTE (85.87%)was higher than the youger's(57.30%) (P<0.05).⑤The most possible blocking positions were the bilateral pulmonary artery and branches (58.55%,63.76%) and next were the artery and branches of inferior lobe of right lung (16.45%,13.42%).⑥Misdiagnosis rate in elderly reached up to 60%, and misdiagnosis diseases included chronic obstructive pulmonary disease, pulmonary infection, coronary heart disease and congestive heart failure, while the younger's was 37.08%, and misdiagnosis diseases were mainly pulmonary infection, pleurisy, coronary heart disease and congestive heart failure.⑦Anticoagulation was mainly therapeutics in both groups (89.13%,82.02%). The application of thrombolys in elderly was 13 cases and the counterpart was 19 cases, which hemorrhage syndrome was not occured in those 32 cases. Recovery rate and improvement rate and mortality of the older were 5.43%, 82.61%, 5.43% respectively while the youger's were 7.30%, 7.08% and 2.25%. There was significant difference by comparison of items above(P<0.05).Conclusion①The ratio of advanced age was higher than that of younger patients in PTE.②The older group always was accompanied by various fundamental diseases, which the independent dangerous factors included malignancy, coronary heart disease and chronic obstructive pulmonary disease.③Clinical manifestation of the elderly PTE was atypical, and cyanosis was common in the elderly PTE.④The most possible blocking positions in older patients were the bilateral pulmonary artery and branches and next were the artery and branches of inferior lobe of right lung.⑤Misdiagnosis rate in elderly of PTE was high. If may be easily misdiagnosed with chronic obstructive pulmonary disease, pulmonary infection, coronary heart disease and congestive heart failure.⑥The death risk in early group was high, and recovery rate was low, and mortality was high in the older group with PTE.