Clinical Characteristics of Elderly Patients with Non-High-Risk Acute Pulmona-ry Embolism
Objective This study aimed to analyze the clinical characteristics of elderly patients with non-high-risk acute pulmona-ry embolism(APE)and evaluate their value in early diagnosis.Methods We retrospectively reviewed the clinical data of 50 elderly patients with non-high-risk APE who were hospitalized and diagnosed at our institution between January 2018 and December 2023.A control group of 50 patients,who underwent pulmonary artery computed tomography angiography but were not diagnosed with APE dur-ing the same period,was included for comparison.Clinical characteristics,laboratory parameters,lower extremity venous ultrasound,e-lectrocardiograms,and echocardiographic findings were analyzed across the two groups.The diagnostic performance of D-dimer was eval-uated using receiver operating characteristic(ROC)curve analysis.Results No significant differences were found between the two groups in terms of gender and age(all P＞0.05).However,the APE group had significantly higher white blood cell counts,C-reactive protein,N-terminal pro-brain natriuretic peptide,and D-dimer levels compared to the control group(all P＜0.05).The incidence of deep vein thrombosis in the lower extremities was also significantly higher in the APE group(P＜0.05).Electrocardiograms findings showed that the SⅠQⅢTⅢ pattern and T-wave inversion in leads V1～V3 occurred more frequently in the APE group(all P＜0.05).In contrast,no significant differences were observed in echocardiographic parameters between the two groups(all P＞0.05).ROC curve analysis revealed that the area under the curve for D-dimer in predicting non-high-risk APE in elderly patients was 0.764(95%confi-dence interval:0.671-0.857).The optimal cutoff value for D-dimer was 2.195 mg/L,with a sensitivity of 94%and a specificity of 52%.Conclusion Elderly patients with non-high-risk APE demonstrate significant differences in inflammatory response,thrombus burden,cardiac function impairment,and Electrocardiograms characteristics compared to those without APE.These indicators,when combined,offer valuable diagnostic insights.However,echocardiography has limited diagnostic utility in this population.
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