BMC Pulmonary Medicine (Jan 2024)

Clinical characteristics and mortality predictors among very old patients with pulmonary thromboembolism: a multicenter study report

  • Xia Zhou,
  • Yuanhua Yang,
  • Zhenguo Zhai,
  • Dingyi Wang,
  • Jieping Lei,
  • Xiaomao Xu,
  • Yingqun Ji,
  • Qun Yi,
  • Hong Chen,
  • Xiaoyun Hu,
  • Zhihong Liu,
  • Yimin Mao,
  • Jie Zhang,
  • Juhong Shi,
  • Zhu Zhang,
  • Sinan Wu,
  • Qian Gao,
  • Xincao Tao,
  • Wanmu Xie,
  • Jun Wan,
  • Yunxia Zhang,
  • Shuai Zhang,
  • Kaiyuan Zhen,
  • Zhonghe Zhang,
  • Baomin Fang,
  • Chen Wang,
  • on behalf of the China pUlmonary thromboembolism REgistry Study (CURES) investigators

DOI
https://doi.org/10.1186/s12890-023-02824-7
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 12

Abstract

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Abstract Background Clinical characteristics of patients with pulmonary thromboembolism have been described in previous studies. Although very old patients with pulmonary thromboembolism are a special group based on comorbidities and age, they do not receive special attention. Objective This study aims to explore the clinical characteristics and mortality predictors among very old patients with pulmonary thromboembolism in a relatively large population. Design and participants The study included a total of 7438 patients from a national, multicenter, registry study, the China pUlmonary thromboembolism REgistry Study (CURES). Consecutive patients with acute pulmonary thromboembolism were enrolled and were divided into three groups. Comparisons were performed between these three groups in terms of clinical characteristics, comorbidities and in-hospital prognosis. Mortality predictors were analyzed in very old patients with pulmonary embolism. Key results In 7,438 patients with acute pulmonary thromboembolism, 609 patients aged equal to or greater than 80 years (male 354 (58.1%)). There were 2743 patients aged between 65 and 79 years (male 1313 (48%)) and 4095 patients aged younger than 65 years (male 2272 (55.5%)). Patients with advanced age had significantly more comorbidities and worse condition, however, some predisposing factors were more obvious in younger patients with pulmonary thromboembolism. PaO2 < 60 mmHg, eGFR < 60 mL/min/1.73m2, malignancy, anticoagulation as first therapy were mortality predictors for all-cause death in very old patients with pulmonary thromboembolism. The analysis found that younger patients were more likely to have chest pain, hemoptysis (the difference was statistically significant) and dyspnea triad. Conclusion In very old population diagnosed with pulmonary thromboembolism, worse laboratory results, atypical symptoms and physical signs were common. Mortality was very high and comorbid conditions were their features compared to younger patients. PaO2 < 60 mmHg, eGFR < 60 mL/min/1.73m2 and malignancy were positive mortality predictors for all-cause death in very old patients with pulmonary thromboembolism while anticoagulation as first therapy was negative mortality predictors.

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