Analysis of Clinical Characteristics of Patients with Sudden In-hospital Pulmonary Embolism
Objective To analyze the clinical characteristics of patients with sudden in-hospital pulmonary embol-ism(PE),thereby providing a basis for improving the clinical diagnosis and treatment of PE.Methods The data of 427 patients with PE admitted to the author's hospital from January 2011 to June 2022 were retrospectively collect-ed.Patients were divided into in-hospital group(n=31)and out-of-hospital group(n=396)based on the time of PE occurrence,the in-hospital group consisted of patients who developed new-onset PE during hospitalization for other diseases,while the out-of-hospital group included those with PE at the time of admission.The European society of cardiology's risk stratification system was used to categorize the in-hospital group further into high-risk subgroup(n=7)and non-high-risk subgroup(n=24).The clinical manifestations of PE patients were analyzed,the differences in clinical data between the in-hospital and out-of-hospital groups,as well as between the high-risk and non-high-risk subgroups were compared.Results Of the 31 cases of PE patients in the in-hospital group,the most common initial symptom was palpitations and chest tightness in 24 cases(77.42％),followed by shortness of breath in 19 cases(61.29％),chest pain in 15 cases(48.39％),cough in 8 cases(25.81％),and syncope in 4 cases(12.90％).The levels of cardiac troponin T,creatine kinase isoenzyme MB(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP),intubation proportions,and hospital costs were significantly higher in the in-hospital group than that in the out-of-hospital group(all P＜0.05).Patients in the high-risk subgroup had significantly higher proportions of syncope and surgery,as well as higher levels of lactate,myoglobin,troponin T,CK-MB,and longer hospital stays compared with the non-high-risk subgroup,while pH was significantly lower than non-high-risk subgroup(all P＜0.05);among the PE patients of the in-hospital group,3 cases experienced syncope leading to death,and one case developed severe ischemic hypoxic encephalopathy;all these occurred in the high-risk subgroup.Conclusion In-hospi-tal PE is still a high-mortality disease threatening hospitalized patients.Syncope as the initial symptom,along with high levels of lactate,myoglobin,cardiac troponin T,CK-MB,and prolonged length of hospital stay hold significant value in assessing the severity of PE,thereby providing reference for clinical treatment.
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