| Objective: Observe the trend of hospital incidence and fatality in ten years. Analyze the risk factors'change and death related-factorsMethods: Collect the cases of pulmonary embolism in our hospital from 2001 to 2010.There are total 303 patients,181 males and 122 females , average age is 56.12(±15.20),48 deaths. Considering the disparity of sample size, we divid the cases into 3 phases to facilitate statistical analysis and observation. Phase1:2001-2005 15 patients, Phase2:2006-2008 88 patients, Phase2:2009-2010 200 patients. According to the European guidelines and the Chinese expert consensus, 10 identified common risk factors were set up for observing, including deep venous thrombosis, phlebeurysma or phlebitis, surgery, trauma and fracture, cardiovascular disease, chronic pulmonary disease, tumor, stroke, pregnancy and perinatal period, interventional therapy. To survey the change of their proportion through the ten years and compare with the past. Research the death-related factors, such as age, gender, risk factors, diagnosis ,treatment and so on, with the control study between death group and non-death group.Results:⑴During the ten years of 2001-2010, the hospital incidence has raised from 0.09‰to 1.12‰,which is lower than the prevalence of 4‰in the USA. The fatality has declined from 73.3% to 12.0%, which is little higher than foreigner date. The incidence of different age and gender has no distinction in statistics. There are the most patiens in the group aged from 50 to 69,which accounts for 44.9%.⑵The proporition of risk factors in the ten years has no change according to statistical analysis. In general, deep venous thrombosis is the most important risk factor with the rate of 49.5%. Secondly surgery and cardiovascular disease has the rate of 31.7% and 30.0% respectively. Then other proporition is like following: phlebeurysma or phlebitis 17.8%, trauma and fracture 14.5%, chronic pulmonary disease 12.5%, tumor 9.9%, stroke 9.9%, interventional therapy 3.6%, pregnancy and perinatal period 3.3%. ⑶Orthopaedic operation is the most common one in all surgery, which accounts for 32.3%. Secondly general gastrointestinal surgery is 12.5% and tumor resection is 11.5%. The average time for suffering PE after surgery is 25(7,75)days. The most common fracture site is lower limb with the rate of 85%. In cardiac disease, coronary heart disease has the highest rate of 54.9%. Secondly pulmonary heart disease has the rate of 33.0%. Lung tumor gets the highest proportion of 34.5% in tumor.⑷Twenty-five patients died in 24 hours after admission , which accounted for 52.1% in all death. The average time from first symptom to death is 3.5(1,10.75)days. Age and gender has no influence on fatality in statistical analysis. In the single and multivariate analysis between death and non-death group, interventional therapy, shock, respiratory failure and right cardiac insufficiency has statistical significance. The fatality of no treatment group is 34.1% , which is obviously higher than thrombolysis group 8.9% and anticoagulation group 9.2%.Conclusion: During the ten years hospital incidence has raised and fatality has declined obviously. The main risk factors are deep venous thrombosis, surgery and cardiovascular disease. Compare with the result of peking union medical college hospital from 1950 to 2000, surgery become the second common risk factor from a infrequent one. Orthopaedic operation has the highest rate in all surgery. The most common fracture site is lower limb and the most common type of heart disease is coronary heart disease and pulmonary heart disease. Lung tumor gets the highest proportion in all tumor. More than half of the deaths died in 24 hours after admission .The average time from first symptom to death is 3.5(1,10.75)days. Age and gender has no influence on fatality in statistical analysis. The patients who has suffered interventional therapy, shock, respiratory failure or right cardiac insufficiency has higher fatality than controls. Both thrombolysis group and anticoagulation group has lower fatality than no treatment group.
|
PDF Full Text Request