Background: The purpose of the study is to investigate the correlation of documented clinical parameters, laboratory findings, severity criteria and risk factors with the hospital outcome of patients with pulmonary embolism.
Methods: The records of 128 patients, mean age 65.8±18.5, with pulmonary embolism, who were hospitalized in pulmonary clinic from 1/1/2006 to 01/09/2016, were studied retrospectively. Predisposing factors, cardiovascular risk factors, clinical signs upon admission-hemodynamic status, disease severity index (PESI scale), echocardiography and laboratory findings (D-dimers, CK-MB) were recorded. In 36 patients (after 1/1/2015), the troponin-T values cTnT), absolute numbers of white blood cells (WBC) and PLR indicators (ratio of platelets/lymphocytes cells) and NLR (ratio of neutrophils/lymphocytes) were also recorded at the 1st and 3rd day of hospitalization .The disease outcomes during hospitalization was associated with the above parameters.
Results: Based on PESI scale, patients were classified into three severity groups: 50/128 patients (39%) of very low and low severity, 42/128 patients (32.9%) of intermediate, 36/128 (28.1%) high and very high severity. Eleven patients died (8.6%). All of them had high severity PESI. Among the three groups, there was found statistically significant difference among the percentages of patients with dilatation of the right ventricle on echocardiography (P<0.05), and patients who were current smokers (P<0.05). The values of WBC and NLR at the last group of 36 patients yielded statistical correlation with the duration of hospitalization (P<0.01, P<0.05 respectively).
Conclusions: The results of this study confirm the clinical importance of PESI scale in predicting in-hospital outcome of pulmonary embolism. Moreover, the smoking habit also seems to be related to the outcome of the disease, while further studies of new biomarkers may contribute to the reliable assessment of disease severity, from the first day of hospitalization.
