Study On Risk Factors And Clinical Characteristics Of 579 Patients With Pulmonary Embolism

Objectives:By comparing with healthy people,the correlation between general demographic characteristics,disease history,clinical characteristics and clinical biochemical indexes of hospitalized pulmonary embolism patients and the disease was analyzed,and the evaluation value of related risk factors and clinical biochemical indexes on pulmonary embolism diseases was discussedMethods:579 patients with pulmonary embolism diagnosed for the first time in Yan an Hospital affiliated to Kunming Medical University from May 2012 to December 2019 were selected as the observation group.Based on the principle of similar age,gender and height,600 healthy people in the health examination department at the same period were randomly collected as the control group,and the general demographic characteristics,disease history,clinical characteristics and clinical biochemical indicators were extracted.Single factor analysis was used to compare the differences of the above-mentioned characteristics between the pulmonary embolism group and the control group.Multivariate logistic regression model was further used to explore the correlation between pulmonary embolism and related characteristics.ROC curve area and other indicators were used to evaluate the evaluation value of clinical biochemical indicators for pulmonary embolism.Results:1.The number of pulmonary embolism cases has increased year by year,with a sharp rise from 2016 to 2019.Among them,the department with the largest number of patients with pulmonary embolism is respiratory and critical diseases.The first symptoms of 579 patients with pulmonary embolism are cough(55.3%),dyspnea(39.6%)and chest pain(37.7%),of which only 36(6.22%)are the "triple syndrome" of chest pain,hemoptysis and dyspnea.2.The average body weight of patients in pulmonary embolism group(65.05±10.23Kg)is higher than that of patients in control group(60.25±8.83Kg),t=-8.628,p<0.001;The proportion of farmers in pulmonary embolism group(39%)was higher than that in control group(10.8%),X2=236.636,p<0.001.3.Patients in pulmonary embolism group had a history of operation(26.8%),smoking(16.4%),limited activity(16.4%),alcohol abuse(9.7%)and pregnancy(3.3%)accounting for a higher proportion than the control group.4.Patients in pulmonary embolism group have a history of acute infectious diseases(51.3%),lower limb venous thrombosis(46.5%),chronic obstructive pulmonary disease(16.1%),diabetes(11.7%),ischemic stroke(9.7%),rheumatic immune disease(7.8%),malignant tumor(5.2%)and coronary heart disease(4.7%)accounting for a higher proportion of the above medical history than patients in the control group,and the difference is statistically significant.5.Multivariate Logistic analysis showed that surgical history(OR=2.958,95%CI1.621-5.398),BMI(OR=1.236,95%CI1.142-1.338),red blood cell distribution width(OR=1.179,95%CI1.133-1.225),C-reactive protein(OR=1.120,95%CI 1.085-1.155),uric acid(OR=1.008,95%CI1.006-1.011)may be independent risk factors for pulmonary embolism.Platelet distribution width(OR=0.671,95%CI0.616-0.745)and oxygen saturation(OR=0.658,95%CI0.609-0.710)may be independent protective factors for pulmonary embolism.6.In the exploration of the evaluation value of oxygen saturation,C-reactive protein,red blood cell distribution width,platelet distribution width,uric acid and BMI for pulmonary embolism,oxygen saturation has the highest comprehensive evaluation value for acute pulmonary embolism,platelet distribution width sensitivity is the highest,and C-reactive protein specificity is the highest.Conclusions:1.The incidence rate of pulmonary embolism is increasing year by year.Patients with smoking,obesity,surgery,limited activity,acute infection,lower limb venous thrombosis and chronic obstructive pulmonary disease are the high incidence population of pulmonary embolism.2.C-reactive protein,surgical history,red blood cell distribution width,uric acid and BMI may be independent risk factors for pulmonary embolism.Platelet distribution width and oxygen saturation may be independent protective factors for pulmonary embolism.3.Oxygen saturation has great evaluation value in PE management.In this study,it has the highest comprehensive evaluation value for acute pulmonary embolism,the critical value is 93.5%.