Prognosis Analysis And Survival Analysis In 310 Patients Of Pulmonary Thromboembolism

Objective To explore adverse factors on therapeutic effect of Pulmonary thromboembolism(PTE) and risk factors on the survival time of PTE.Methods This was a single-center retrospective study of inpatients admitted from Zhongshan Hospital, Fudan University with a diagnosis of PTE. The diagnosis of PE was objectively confirmed by Computed tomography pulmonary angiography(CTPA)or ventilation perfusion lung scan(V/Q scan). Multivariate logistics regression analysis was applied to investigate risk factors for curative effect and multivariate COX proportional hazard regression model were used to examine the survival time of pulmonary thromboembolism.Results Of the 310 patients with PTE, the minimum age was 18 year-old, the maximum age was 86 year-old, average age was( 63.28 ± 15.30)year-old. Among them, 285 cases were male(53.2%), female cases were female(46.8%). Good curative effect was achieved in 285 cases(40%), and invalid treatment in 25 cases. We built multivariable logistic regression models to measure the association between prognostic factors and adverse outcomes. Seven factors that had been screened out in the univariate analyses were introduced into a multivariate logistic regression model.Baseing on α=0.05 level,four predictors associated with adverse outcomes were screened out. According to the absolute value of standardized partial regression coefficient, the strongest poor prognostic factor of a PE was massive pulmonary embolism(PE), hyoxemia, leukocytosis,cancer in the adjusted model(seen in table 4). There were 81 cases completed the 24-month follow-up study of the survival time, and a total of 28 cases of patients died. Further analysis by COX proportional hazard regression model showed that pulmonary artery systolic pressure(Pasp) increased group(≥50mm Hg)had 9.240 times greater risk of death compared to non-increased group when all cases of two groups developed cancer. Under the same level of Pasp, the patient with cancer had 3.7 times greater risk of death compared to the non-cancer patient( seen in table 5).Conclusions Massive PE, hyoxemia, leukocytosis, cancer may be considered to be associated with poor prognosis of PTE. Pasp increased group(≥50mm Hg)and PTE with cancer may impact on survival time,which Increased risk of death.