The Retrospective Analysis Of Factors Related To The Incidence And Mortality Of Pulmonary Embolism

Objective: We choose the pulmonary artery CTA examination as diagnosis criteria for Pulmonary Embolism,and retrospectively analyzed and summarizing the clinical data as well as the results of anticoagulant therapy of the patients with PE and the controls that in order to giving clinicians some hints for Pulmonary Embolism clinical characteristics and prognosis of different treatments.Methods: Collecting 158(73 cases in male,85 cases in female)patients who were suspected with PE and checked CTA from November 2013 to July 2016 in the Eastern Division of the First Hospital of Jilin University.We divided them into two groups: the PE group 73 cases(35 men,47 women,mean age 65.83±13.63 years)and the controls 85 cases(41 men,44 women,mean age 67.46±11.62 years).Comparing the general information,clinical manifestation,examination,treatment of the two groups.Collecting the time of symptom onset of the patients with PE and the required time for diagnosis,following the patients and assessing the present whether taking the anticoagulant therapy,the side-effects,death factors and analyzing statistically the risk factors of the occurrence and death of Pulmonary Embolism.Results: 1.The positive rate of Pulmonary Embolism in our hospital is 46.20%(73/158).The required time of diagnosis is 0~406 hours(60.71±74.56 hours).The average length of stay is(12.75±6.25 days).The number of receiving anticoagulant therapy during the hospital is 67 cases(91.79%)and the controls is 6 cases(8.22%).2.In the univariate analysis,1)Women(52.05%)is more than men(47.95%)in the Pulmonary Embolism group,and the average age of Pulmonary Embolism group is lower than that of the control group(P>0.05).2)The percentage of bruise,smoking,hypertension,diabetes,heart failure,nephroticsyndrome are higher in the Pulmonary Embolism group than in the control group(P>0.05).3)The percentages of chest distress and shortness of breath are higher in the Pulmonary Embolism group than in the control group(P<0.05).The percentage of chest pain,dyspnea,fainting and hemoptysis are higher in the Pulmonary Embolism group than in the control group(P>0.05).4)The percentages of the patients with the increased D-dimer,the decreased arterial partial pressure of oxygen,deep venous thrombosis are higher in the Pulmonary Embolism group than in the control group(P>0.05).3.28 people were followed after discharged(follow-up rate was 38.36%,12 men,16 women),the follow-up time was 12.03±10.33 months,the loss ratio of follow-up was 45 people(61.6%),the reasons were out of contact,the wrong information,or incompatibility.In the anticoagulant group,24 people(35.82%)were traced,no death.,The duration of anticoagulant therapy was 38.53±16.47 days.Among which receiving the anticoagulant therapy more than 3 months only 11 people,in the controls was 13 people.According to the bleeding standard of WHO,4 cases appear as grade 1.In the other group,3 of them deaths(1 due to PE,and others due to therioma and already existed before the PE).The reasons of not accepting anticoagulant were the existed therioma,monitoring cannot be carried out,as well as lacking of the knowledge of PE.4.In the follow-up,21 cases(87.5%)in the PE group that accepted anticoagulant therapy had improved the symptoms,with the contrary of 3 cases(12.5%).In the other group,1 case felt better,but 3 cases were still discomfort(including 1 PE case and 2 therioma cases).Conclusions:1.Sex is not the significant difference in Pulmonary Embolism.2.The onset symptom is mostly shortness of breath as the main clinical manifestation.3.Although the proportion of PE patients who received the anticoagulant therapy is high,the number of the PE patients continuing the anticoagulant therapy more than 3 months is only 45.8%.Thus,strengthening the intensity of follow-up and monitoring the anticoagulant therapy is particularly important.4.During the follow-up,the PE patients who were accepted anticoagulant therapy have a great improves compared the others.And the survival rate of patients who were accepted anticoagulant therapy is higher than those who were not.