Analysis of risk factors for the prediction of short-term adverse event associated with acute non-high-risk pulmonary embolism_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

SUN Borui , HU Jiaxin , GE Shanhui , REN Jianwei ,  ZHU Guangfa

Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding?author：

ZHU Guangfa, Email: gfzhu63@hotmail.com

Keywords：

Pulmonary thromboembolism; adverse event; risk factor

DOI：

10.7507/1671-6205.202110058

Video：

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Objective To evaluate the prognostic value of several indexes of laboratory and ultrasonic cardiogram for adverse events in 3 months following the diagnosis of acute non-high-risk pulmonary embolism. Methods A total of 266 cases of acute non-high-risk pulmonary embolism patients diagnosed and treated in Beijing Anzhen Hospital during 2016 to 2017 were retrospectively analyzed. The patients were divided into a bad event group and a control group according to whether there was a bad event happened in 3 months following the diagnosis. The general data, indexes of laboratory and ultrasonic cardiogram were compared. Univariate and multivariate COX regression analysis were conducted to explore independent risk factors for 3 months’ poor prognosis. Results The bad outcome group had a significantly higher value of the proportion of suffering from connective disease and active cancer, C-reaction protein, monocyte/lymphocyte ratio (MLR) and urea while a significantly lower level of red blood cell count and hemoglobin compared with the control group (all P<0.05). Univariate and multivariate COX regression analysis showed that both the MLR (hazard ratio 14.59, 95% confidence interval 1.48 - 143.69, P=0.02) and suffering from connective disease (hazard ratio 5.85, 95% confidence interval 1.11 - 30.81, P=0.04) remain significantly different between the bad events group and the control group. Conclusion MLR at the admission may be related to the 3 months death of acute non-high-risk pulmonary embolism.

Citation： SUN Borui, HU Jiaxin, GE Shanhui, REN Jianwei, ZHU Guangfa. Analysis of risk factors for the prediction of short-term adverse event associated with acute non-high-risk pulmonary embolism. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(1): 37-42. doi: 10.7507/1671-6205.202110058 Copy

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10.	K?se N, Y?ld?r?m T, Ak?n F, et al. Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism. Bosnian J Basic Med, 2020, 20(2): 248-253.
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13.	王渝勝. sPESI聯合纖維蛋白原/白蛋白比值對急性非高危肺栓塞患者的預后價值. 山東大學, 2021. DOI: 10.27272/d.cnki.gshdu.2021.001110.
14.	王渝勝, 王華蕊, 朱玲. sPESI聯合RDW和NLR對急性非高危肺栓塞患者預后的預測價值. 中國急救醫學, 2021, 41(4): 302-306.
15.	肖華葉, 梁斌苗, 歐雪梅. 中性粒細胞與淋巴細胞比值在慢性阻塞性肺疾病急性加重期中的價值. 中國呼吸與危重監護雜志, 2021, 20(2): 85-90.
16.	秦志均, 劉磊, 孫群, 等. 新型冠狀病毒肺炎患者外周血細胞動態變化特征及預測價值. 中國呼吸與危重監護雜志, 2020, 19(5): 457-462.
17.	徐英, 蔣萍, 楊明金, 等. 紅細胞分布寬度與老年支氣管擴張癥急性加重期嚴重程度的相關性分析. 中國呼吸與危重監護雜志, 2019, 18(4): 348-351.
18.	Bedel C, Korkut M, Arma?an HH. Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary. Bosnian J Basic Med, 2021, 21(4): 501.
19.	Jiménez D, Yusen RD, Otero R, et al. Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy. Chest, 2007, 132(1): 24-30.
20.	Weeda ER, Caranfa JT, Lyman GH, et al. External validation of three risk stratification rules in patients presenting with pulmonary embolism and cancer. Support Care Cancer, 2019, 27(3): 921-925.
21.	Quezada CA, Bikdeli B, Villén T, et al. Accuracy and interobserver reliability of the simplified pulmonary embolism severity index versus the Hestia criteria for patients with pulmonary embolism. Acad Emerg Med, 2019, 26(4): 394-401.
22.	Vuilleumier N, Simona A, Méan M, et al. Comparison of cardiac and non-cardiac biomarkers for risk stratification in elderly patients with non-massive pulmonary embolism. PLoS One, 2016, 11(5): e0155973.

1. 喬力松, 許小毛, 楊鶴, 等. 肺血栓栓塞癥合并下肢深靜脈血栓臨床分析. 中國呼吸與危重監護雜志, 2021, 20(7): 509-512.
2. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Society (ERS). Eur Heart J, 2020, 41(4): 543-603.
3. Wenger N, Sebastian T, Engelberger RP, et al. Pulmonary embolism and deep vein thrombosis: similar but different. Thromb Res, 2021, 206: 88-98.
4. 沈芳, 張景熙, 劉錦銘, 等. 慢性阻塞性肺疾病加重期合并靜脈血栓栓塞癥的危險因素分析. 中國呼吸與危重監護雜志, 2019, 18(5): 427-431.
5. Th?lin C, Hisada Y, Lundstr?m S, et al. Neutrophil extracellular traps: villains and targets in arterial, venous, and cancer-associated thrombosis. Arterioscl Throm Vas, 2019, 39(9): 1724-1738.
6. Owens AP 3 rd, Mackman N. Microparticles in hemostasis and thrombosis. Circ Res, 2011, 108(10): 1284-1297.
7. Engelmann B, Massberg S. Thrombosis as an intravascular effector of innate immunity. Nat Rev Immunol, 2013, 13(1): 34-45.
8. Khan F, Tritschler T, Kahn SR, et al. Venous thromboembolism. Lancet, 2021, 398(10294): 64-77.
9. 王夢瑤, 張薇, 郭友芳, 等. 單核細胞/淋巴細胞比值與呼吸系統疾病評估相關性的研究進展. 醫學綜述, 2021, 27(15): 3045-3049.
10. K?se N, Y?ld?r?m T, Ak?n F, et al. Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism. Bosnian J Basic Med, 2020, 20(2): 248-253.
11. Telo S, Kulu?ztürk M, Deveci F, et al. The relationship between platelet-to-lymphocyte ratio and pulmonary embolism severity in acute pulmonary embolism. Int Angiol, 2019, 38(1): 4-9.
12. Jurin I, Trkulja V, Ajduk M, et al. Red cell distribution width in acute pulmonary embolism patients: a simple aid for improvement of the 30-day mortality risk stratification based on the pulmonary embolism severity index. Heart Lung, 2019, 48(5): 436-445.
13. 王渝勝. sPESI聯合纖維蛋白原/白蛋白比值對急性非高危肺栓塞患者的預后價值. 山東大學, 2021. DOI: 10.27272/d.cnki.gshdu.2021.001110.
14. 王渝勝, 王華蕊, 朱玲. sPESI聯合RDW和NLR對急性非高危肺栓塞患者預后的預測價值. 中國急救醫學, 2021, 41(4): 302-306.
15. 肖華葉, 梁斌苗, 歐雪梅. 中性粒細胞與淋巴細胞比值在慢性阻塞性肺疾病急性加重期中的價值. 中國呼吸與危重監護雜志, 2021, 20(2): 85-90.
16. 秦志均, 劉磊, 孫群, 等. 新型冠狀病毒肺炎患者外周血細胞動態變化特征及預測價值. 中國呼吸與危重監護雜志, 2020, 19(5): 457-462.
17. 徐英, 蔣萍, 楊明金, 等. 紅細胞分布寬度與老年支氣管擴張癥急性加重期嚴重程度的相關性分析. 中國呼吸與危重監護雜志, 2019, 18(4): 348-351.
18. Bedel C, Korkut M, Arma?an HH. Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary. Bosnian J Basic Med, 2021, 21(4): 501.
19. Jiménez D, Yusen RD, Otero R, et al. Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy. Chest, 2007, 132(1): 24-30.
20. Weeda ER, Caranfa JT, Lyman GH, et al. External validation of three risk stratification rules in patients presenting with pulmonary embolism and cancer. Support Care Cancer, 2019, 27(3): 921-925.
21. Quezada CA, Bikdeli B, Villén T, et al. Accuracy and interobserver reliability of the simplified pulmonary embolism severity index versus the Hestia criteria for patients with pulmonary embolism. Acad Emerg Med, 2019, 26(4): 394-401.
22. Vuilleumier N, Simona A, Méan M, et al. Comparison of cardiac and non-cardiac biomarkers for risk stratification in elderly patients with non-massive pulmonary embolism. PLoS One, 2016, 11(5): e0155973.

Chinese Journal of Respiratory and Critical Care Medicine

Analysis of risk factors for the prediction of short-term adverse event associated with acute non-high-risk pulmonary embolism

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