The Research Of Related Factors About Patients With Pulmonary Embolism Recrurrence

Objective: Recurrence is one of the main adverse prognostic eventsamong patients with pulmonary embolism. There is no consistent conclusionson the rate of recurrence and related risk factors. In this study, patients withdiagnosis of pulmonary embolism were observed by long-term follow-up,aimed at discovering the recurrence and related risk factors.Methods: Cases of patients diagnosed by Spiral CT pulmonaryangiography (CTPA) or lung ventilation/perfusion scan in The SecondHospital of Hebei Medical University from January1998to June2011wereanalyzed retrospectively after an average of28months (the date of diagnosisto the161st month) follow-up. Univariate analysis (t test or χ2test) selected P<0.10variables into the regression model for further analysis and multivariateunconditional logistic regression analysis of the lines that may be significantfactors in progress, looking for the related risk factors of recurrence.Results: During the161months follow-up,48in385cases of pulmonaryembolism recurrent. The constituent ratio as follows:1-year50.0%(24cases),2-year22.92%(11cases),3-year10.42%(5cases),4-year5.41%(2cases),5-year5.41%(2cases),6-year5.41%(2cases),7-year2.70%(1case),8-year2.70%(1case). Univariate analysis (P <0.10): persistently positive D-dimer,right heart dysfunction, idiopathic PTE, short duration of anticoagulanttreatment (<3months), age>65, smoking, hypertension, deep venousthrombosis, hypoxemia and so on are related with recurrence(P＜0.05).Butmultivariate unconditional logistic regression analysis denoted that onlypersistently positive D-dimer(OR=28.257), right heart dysfunction (OR=14.806), idiopathic PTE(OR=7.839), short duration of anticoagulant treatment(<3months, OR=5.464), age>65(OR=9.518), smoking (OR=5.464) are theindependent risk factors (P <0.05). And the recurrence rate caused by two or more factors is of nearly three times than the case of single factor(87.50%vs21.66%,P=0.000).Conclusion: The highest risk of recurrence occurred during the first yearand the recurrence rate decreased during follow-up. Among all the risk factorsof pulmonary embolism, the persistently positive D-dimer, right ventriculardysfunction, idiopathic PTE, short durtion of anticoagulant treatment (<3months), age>65, smoking are the independent risk factors of recurrence.