Медицинский совет (Apr 2019)

Risk factors associated with the development of death events during the first year of follow-up after pulmonary thromboembolism

  • S. A. Berns,
  • E. A. Schmidt,
  • A. G. Neeshpapa,
  • A. A. Potapenko,
  • K. V. Smirnov,
  • E. V. Gorbunova,
  • I. I. Zhidkova,
  • I. N. Mamchur,
  • O. L. Barbarash

DOI
https://doi.org/10.21518/2079-701X-2019-5-80-85
Journal volume & issue
Vol. 0, no. 5
pp. 80 – 85

Abstract

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Purpose: to identify the factors associated with the development of death events during the year follow-up after hospitalization for pulmonary embolism (PE). Materials and methods: 93 patients with PE discharged to the outpatient stage of observation were studied. 45 (61,6%) patients were female with an average age of 66 years. The examination of patients at the stage of inclusion in the study consisted of standard methods of examination for this pathology. The diagnosis was confirmed by multislice computed tomography. Follow-up was 12 months. Statistical analysis was performed using the MedCalc Version 16.2.1. Results: during the one-year follow-up period 62 (66,7%) patients with PE were alive but 11 patients (11,8%) died, and no information was obtained about 20 patients. The causes of death were as follows: the development of recurrent PE – 4 (36,4%) patients, cancer – 3 patients (27,3%), stroke – 2 (18,1%), one patient (9,1%) died due to severe heart failure and one – myocardial infarction. A comparative analysis in the groups of alive patients (n = 62) and patients with a fatal events (n = 11) showed that the dead patients were older (78 (68; 81) vs. 65 (49; 75) years; p = 0,003), had a higher PESI score (119,0 (99,7; 137,2) vs. 88,0 (68,0; 108,0); p = 0,016) and were less compliant to prolonged anticoagulant therapy during the one year of observation (45,5% of patients (n = 5) vs. 82,3% ( = 51); p = 0,015). The ROC curve determined that a high risk of death during the one year after PE is associated with age over 70 years (p = 0,0001) and more than 95 points by PESI in the hospital period (p = 0,0001). Conclusion: The death events were developed in 11,8% of cases in patients with pulmonary embolism during the first year of follow-up. The death outcomes were significantly associated with elderly age, intermediate and high risk by PESI in the hospital period and low compliance to anticoagulant therapy extended during the year after pulmonary embolism.

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