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Clinical characteristics and mortality predictors among very old patients with pulmonary thromboembolism: a multicenter study report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年1月10日

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  • Xia Zhou,
  • Yuanhua Yang,
  • Zhenguo Zhai,
  • Dingyi Wang,
  • Jieping Lei,
  • Xiaomao Xu,
  • Yingqun Ji,
  • Qun Yi,
  • Hong Chen,
  • Xiaoyun Hu,
  • Zhihong Liu,
  • Yimin Mao,
  • Jie Zhang,
  • Juhong Shi,
  • Zhu Zhang,
  • Sinan Wu,
  • Qian Gao,
  • Xincao Tao,
  • Wanmu Xie,
  • Jun Wan,
  • Yunxia Zhang,
  • Shuai Zhang,
  • Kaiyuan Zhen,
  • Zhonghe Zhang,
  • Baomin Fang,
  • Chen Wang,
  • Jifeng Li,
  • He Yang,
  • Lan Wang,
  • Haixia Zhou,
  • Maoyun Wang,
  • Xiaohui Wang,
  • Qin Luo,
  • Junping Fan,
  • Jun An,
  • Mian Zeng,
  • Xia Li,
  • Ling Zhu,
  • Yi Liu,
  • Kejing Ying,
  • Guofeng Ma,
  • Chao Yan,
  • Lixia Dong,
  • Wei Zhou,
  • Chong Bai,
  • Wei Zhang,
  • Liangxing Wang,
  • Yupeng Xie,
  • Xiaoying Huang,
  • Chen Qiu,
  • Yazhen Li,
  • Yingyun Fu,
  • Shengguo Liu,
  • Shengqing Li,
  • Jian Zhang,
  • Xinpeng Han,
  • Qixia Xu,
  • Xiaoqing Li,
  • Yingying Pang,
  • Beilei Gong,
  • Ping Huang,
  • Yanwei Chen,
  • Jiming Chen,
  • Guochao Shi,
  • Yongjie Ding,
  • Zhaozhong Cheng,
  • Li Tong,
  • Zhuang Ma,
  • Lei Liu,
  • Luning Jiang,
  • Zhijun Liang,
  • Chaosheng Deng,
  • Minxia Yang,
  • Dawen Wu,
  • Shudong Zhang,
  • Lijun Kang,
  • Fangfei Yu,
  • Xuewei Chen,
  • Dan Han,
  • Shasha Shen,
  • Guohua Sun,
  • Yutao Hou,
  • Baoliang Liu,
  • Xiaohong Fan,
  • Ping Zhang,
  • Ruhong Xu,
  • Zaiyi Wang,
  • Cunzi Yan,
  • Chunxiao Yu,
  • Zhenfang Lu,
  • Jing Hua,
  • Zhenyang Xu,
  • Hongxia Zhang,
  • Jinxiang Wang,
  • Xiaohong Yang,
  • Ying Chen,
  • Yongjun Tang,
  • Wei Yang,
  • Nuofu Zhang,
  • Linli Duan,
  • Simin Qing,
  • Chunli Liu,
  • Lian Jiang,
  • Hongda Zhao,
  • Chengying Liu,
  • Yadong Yuan,
  • Xiaowei Gong,
  • Xinhong Zhang,
  • Chunyang Zhang,
  • Shuyue Xia,
  • Hui Jia,
  • Yunxia Liu,
  • Dongmei Zhang,
  • Yuntian Ma,
  • Lu Guo,
  • Jing Zhang,
  • Lina Han,
  • Xiaomin Bai,
  • Guoru Yang,
  • Guohua Yu,
  • Ruian Yang,
  • Jingyuan Fan,
  • Aizhen Zhang,
  • Rui Jiang,
  • Xueshuang Li,
  • Yuzhi Wu,
  • Jun Han,
  • Jingping Yang,
  • Xiyuan Xu,
  • Baoying Bu,
  • Chaobo Cui,
  • Ning Wang,
  • Yonghai Zhang,
  • Jie Duo,
  • Yajun Tuo,
  • Yipeng Ding,
  • Heping Xu,
  • Dingwei Sun,
  • Xiangyan Zhang,
  • Weijia Liu,
  • Hongyang Wang,
  • Yuan Wang,
  • Aishuang Fu,
  • Songping Huang,
  • Qinghua Xu,
  • Wenshu Chai,
  • Jing Li,
  • Yanping Ye,
  • Wei Hu,
  • Jin Chen,
  • Bo Liu,
  • Lijun Suo,
  • Changcheng Guo,
  • Ping Wang,
  • Jinming Liu,
  • Qinhua Zhao,
  • Le Kang,
  • Jianying Xu,
  • Lifen Zhao,
  • Mengyu Cheng,
  • Wei Duan,
  • Qi Wu,
  • Li Li,
  • Xiuqing He,
  • Yueyue Li,
  • Gang Chen,
  • Yunxia Zhao,
  • Zixiao Liu,
  • Guoguang Xia,
  • Tianshui Li,
  • Nan Chen,
  • Xiaoyang Liu,
  • Tao Bian,
  • Yan Wu,
  • Huiqin Yang,
  • Xiaoli Tang,
  • Yiwen Zhang,
  • Faguang Jin,
  • Yanli Chen,
  • Yanyan Li,
  • Miaochan Lao,
  • Liang Dong,
  • Guangfa Zhu,
  • Wenmei Zhang,
  • Liangan Chen,
  • Zhixin Liang,
  • Liping Cui,
  • Cenfeng Xia,
  • Jin Zhang,
  • Peng Zhang,
  • Lianxiang Guo,
  • Sha Niu,
  • Sichong Yu,
  • Guangjie Liu,
  • Xinmao Wang,
  • Yanhua Lv,
  • Zhenyu Liang,
  • Shaoxi Cai,
  • Shuang Yang,
  • Xinyi Zhang,
  • Jiulong Kuang,
  • Yanyan Ding,
  • Yongxiang Zhang,
  • Xuejun Guo,
  • Yanmin Wang,
  • Jialie Wang,
  • Ruimin Hu,
  • Lin Ma,
  • Yuan Gao,
  • Rui Zheng,
  • Zhihong Shi,
  • Hong Li,
  • Yingqi Zhang,
  • Guanli Su,
  • Zhiqiang Qin,
  • Guirong Chen,
  • Xisheng Chen,
  • Zhiwei Niu,
  • Jinjun Jiang,
  • Shujing Chen,
  • Tiantuo Zhang,
  • Hongtao Li,
  • Jiaxin Zhu,
  • Yuqi Zhou,
  • Yinlou Yang,
  • Jiangtao Cheng,
  • Jie Sun,
  • Yanwen Jiang,
  • Jianhua Liu,
  • Yujun Wang,
  • Ju Yin,
  • Lanqin Chen,
  • Min Yang,
  • Ping Jiang,
  • Hongbo Liu,
  • Guohua Zhen,
  • Kan Zhang,
  • Yixin Wan,
  • Hongyan Tao

摘要

Background

Clinical characteristics of patients with pulmonary thromboembolism have been described in previous studies. Although very old patients with pulmonary thromboembolism are a special group based on comorbidities and age, they do not receive special attention.

Objective

This study aims to explore the clinical characteristics and mortality predictors among very old patients with pulmonary thromboembolism in a relatively large population.

Design and participants

The study included a total of 7438 patients from a national, multicenter, registry study, the China pUlmonary thromboembolism REgistry Study (CURES). Consecutive patients with acute pulmonary thromboembolism were enrolled and were divided into three groups. Comparisons were performed between these three groups in terms of clinical characteristics, comorbidities and in-hospital prognosis. Mortality predictors were analyzed in very old patients with pulmonary embolism.

Key results

In 7,438 patients with acute pulmonary thromboembolism, 609 patients aged equal to or greater than 80 years (male 354 (58.1%)). There were 2743 patients aged between 65 and 79 years (male 1313 (48%)) and 4095 patients aged younger than 65 years (male 2272 (55.5%)). Patients with advanced age had significantly more comorbidities and worse condition, however, some predisposing factors were more obvious in younger patients with pulmonary thromboembolism. PaO2 < 60 mmHg, eGFR < 60 mL/min/1.73m2, malignancy, anticoagulation as first therapy were mortality predictors for all-cause death in very old patients with pulmonary thromboembolism. The analysis found that younger patients were more likely to have chest pain, hemoptysis (the difference was statistically significant) and dyspnea triad.

Conclusion

In very old population diagnosed with pulmonary thromboembolism, worse laboratory results, atypical symptoms and physical signs were common. Mortality was very high and comorbid conditions were their features compared to younger patients. PaO2 < 60 mmHg, eGFR < 60 mL/min/1.73m2 and malignancy were positive mortality predictors for all-cause death in very old patients with pulmonary thromboembolism while anticoagulation as first therapy was negative mortality predictors.