Value Of Hemographic Indices In The Evaluation And Prognosis In Patients With Acute Pulmonary Embolism

Objective The aim of this study is to explore the value of hematological parameters such as white blood cell,neutral-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and red blood cell distribution width(RDW)in risk stratification and prognosis assessment of patients with acute pulmonary embolism(APE).Methods A retrospective survey of 371 APE patients diagnosed in hospital from January 2005 to April 2017 in the First Affiliated Hospital of Anhui Medical University.A total of 371 patients were enrolled,including 185 males and 186 females with an average age of(60± 15)years.The diagnosis of APE is in accordance with the European Guidelines for the Diagnosis and Treatment of Acute Pulmonary Embolism.Investigate the following by unified questionnaire: basic information(such as age,gender),vital signs(such as blood pressure,heart rate,oxygen saturation,etc.),clinical manifestations(such as syncope),risk factors(such as long-term bed,Chronic lung disease,chronic heart failure,etc.),laboratory tests such as blood routine,D-dimer,C-reactive protein,cardiac troponin,etc.,as well as imaging data such as computed tomography pulmonary angiography.According to the median of NLR,PLR and RDW,they were divided into two groups.According to the patient's exit,they were divided into surviving group and death group.According to sPESI,they were divided into sPESI low-risk group and high risk group.General data and laboratory tests were compared between the two groups.All continuous variables were tested using the Kolmogorov-Smironor test to determine if they were normally distributed.Kolmogorov-smironor tests was used to examine continuous variables to determine whether they are normally distributed.T test was used for quantitative data between groups that were in line with normal distribution,rank sum test was used for quantitative data and rank variables that were not in line with normal distribution,and chi-square test or Fisher's exact probability method was used for qualitative data.When significant differences were observed in univariate analyses,multivariate logistic regression analysis was used to test independent predictors of in-hospital mortality in patients with pulmonary embolism.Results(1)Comparing the high NLR group with the low NLR group,the difference in diastolic blood pressure(P = 0.018),oxygen saturation(P = 0.048),chronic lung disease(P =0.047),long-term bed rest(P = 0.005),sPESI(P = 0.011)were statistically significant.The age(P = 0.008),diastolic blood pressure(P = 0.034),chronic lung disease(P =0.019),and long-term bed rest(P = 0.005)were significantly different in the high PLR group compared with the low PLR group.The systolic blood pressure(P = 0.013),combined malignant tumor(P = 0.008),and sPESI(P < 0.001)were significantly different in the high RDW group compared with the low RDW group;(2)Comparing sPESI high-risk group with low-risk group,the difference in RDW level(P < 0.001),white blood cells(P = 0.001),neutrophils(P = 0.001),NLR(P < 0.001),cardiac troponin(cTnI,P = 0.043)were statistically significant;Comparing the surviving group with death group,RDW level(P = 0.012),white blood cell count(P = 0.005),neutrophil count(P < 0.001),lymphocyte count(P = 0.004),NLR(P < 0.001),PLR(P= 0.002)were statistically significant;(3)The results of multivariate analysis showed that: NLR(OR: 1.168;95% CI: 1.014-1.345),sPESI(OR: 2.933;95% CI: 1.829-4.704)were independent risk factors for hospital mortality of APE(P < 0.05).Conclusion NLR and sPESI are independent risk factors for hospital mortality in patients with APE.High NLR and sPESI indicated a poor prognosis.