One clinical center experience of outcome in patients with acute pulmonary embolism in 2018

Acute pulmonary embolism (PE) is the third most common cause of death in hospitalized patients. The prognosis of patients with PE depends on various factors including patients’ general condition and presence of co-morbidities. The aim of this study was to evaluate the vital signs and the presence of co-morbidities from patients’ medical records, that could affect treatment outcome in patients diagnosed PE. A retrospective study was made to evaluate vital signs and co-morbidities in medical records among hospitalized patients with diagnosis ICD-10 I26 from January to December 2018. Data were processed by IBM SPSS Statistics 22 program. A total of 108 patients were included - female 70 (65%), male 38 (35%). Median age was 74 (SD 11.9 years). The patients were divided into two groups according to hospital outcome – survivors 95 (84%) and non-survivors 15 (16%). Mann Whitney U test gave statistically significant association between presence of chronic heart failure (CHF) ( III-IV functional class by NYHA) (U=22.22; p=0.001), chronic kidney disease (CKD) (stage > II) (U=898.0; p=0.045) and old myocardial infarction (MI) (U=873.0; p=0.043) between both groups. There was statistically significant difference in distribution of systolic (SBP) (U=761.500; p=0.041) mean 117.0 (SD 32.7) vs 136.5 (SD 36.9), diastolic blood pressure (DBP) (U=785.500; p=0.019) mean 68.8 (SD 16.6) vs 81.9 (SD 25.5); in distribution of PESI (U=353.5; p=0.019) mean 162.4 (SD 45.4) vs 133.8 (SD 50.3) and of bed days (U=1532.0; p=0.0001) mean 4.9 (SD 3.9) vs 14.2 (SD 7.6) between non-survivors and survivors. In presence of CHF, CKD, old MI, low SBP and DBP, high score of PESI, it would be reasonable to start therapy without radiological findings. To reduce risk of mortality, it would be suggested to improve diagnostic algorithm to provide faster initiation of the therapy.