Open AccessAnalysis of the Occurrence of Acute Pulmonary Embolism in the ICU Ward and Related Risk Factors Predicting Its Severity
Author(s) -
Chun Fu,
Yuan Yuan Chen,
Fubao Zhu,
Jian Liu
Publication year - 2022
Publication title -
the heart surgery forum/the heart surgery forum
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 38
eISSN - 1522-6662
pISSN - 1098-3511
DOI - 10.1532/hsf.4525
Subject(s) - medicine , intensive care unit , pulmonary embolism , cardiology
Objective: To investigate the occurrence of acute pulmonary embolism in the intensive care unit (ICU) and analyze the related risk factors for predicting its severity.Methods: From January 2016 to December 2020, 83 patients with acute pulmonary embolism in the intensive care unit of Peking University People's Hospital were selected as the research subjects, including 34 males (40.96%) and 49 females (59.04%), with an average age of 62.06±16.83 years. The patients were divided into a high-risk group (N = 31), medium-risk group (N = 32), and low-risk group (N = 20), according to the guidelines for diagnosis and treatment of acute pulmonary embolism issued by ASH in 2020. The clinical characteristics, treatment, and prognosis of the three groups were summarized, and the severity of the patients could be predicted and the related risk factors affecting prognosis were analyzed.Results: There were significant statistical differences in respiratory rate, syncope as the first symptom, bilateral pulmonary embolism, and APACHE-II score among the three groups (P 0.05). However, in the medium-risk group, the laboratory indexes tended to increase, in terms of treatment and outcome, thrombolysis rate, and inferior vena cava filter implantation rate. ICU stay (> 2 weeks) of the high-risk group was significantly higher than those of the other two groups, with significant statistical difference (P < 0.05). Logistic regression analysis showed that respiratory rate (or = 1.778,95% CI 1.043-3.032, P = 0.034), D-Dimer (or = 1,95% CI 1.0-1.0, P = 0.006), and APACHE-II score (or = 1.879,95% CI 1.398-2.527, P = 0.000) were independent risk factors for predicting the severity of APE patients in the ICU ward.Conclusion: Acute pulmonary embolism (APE) is a critical disease in ICU. By monitoring BNP, cTnI and D-dimer, we can identify critical patients with APE early. In addition, we found that respiratory rate, D-dimer, and APACHE-II score were independent risk factors for predicting the severity of APE patients in the ICU. Clinically, APE can be identified early. The diagnosis, treatment rate, and prognosis can be improved by monitoring these indicators.