Risk factors associated with provoked pulmonary embolism

Abstract

Background/AimsThis study aimed to investigate the risk factors associated with provoked pulmonary embolism (PE).MethodsThis retrospective cohort study included 237 patients with PE. Patients that had transient risk factors at diagnosis were classified as having provoked PE, with the remaining patients being classified as having unprovoked PE. The baseline clinical characteristics and factors associated with coagulation were compared. We evaluated the risk factors associated with provoked PE.ResultsOf the 237 PE patients, 73 (30.8%) had provoked PE. The rate of respiratory failure and infection, as well as the disseminated intravascular coagulation score and ratio of right ventricular diameter to left ventricular diameter were significantly higher in patients with provoked PE than in those with unprovoked PE. The protein and activity levels associated with coagulation, including protein C antigen, protein S antigen, protein S activity, anti-thrombin III antigen, and factor VIII, were significantly lower in patients with provoked PE than in those with unprovoked PE. Multivariate analysis showed that infection (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.4) and protein S activity (OR, 0.97; 95% CI, 0.95 to 0.99) were significantly associated with provoked PE.ConclusionsProtein S activity and presence of infection were important factors associated with provoked PE. We should pay attention to the presence of infection in patients with provoked PE.

Bilateral Massive Pulmonary Embolism on Disseminated Intravascular Coagulation (DIVC) after Severe Postpartum Haemorrhage

“…From the biological point of view, the Blood Formula count had revealed platelets with 212,000 elements per mm 3 , an HB level of 12 g/dl and a hypokalemia of 3.4. This bleeding facilitated the uncontrolled systemic activation of the hemostatic system to simultaneous generalized microvascular thrombosis [7] leading to heart failure in our patient. The venous thrombotic risk major is based on risk factors realeted to the patient that are either transient (prolonged immobilization of more than 3 days, fractures of the lower limbs in the last 3 months, travel, hormones) or permanent [9] [14].…”

“…Physiological changes in haemostasis expose the pregnant woman to the risk of thromboembolic events [4] [5] [6] [7] [8]. In the case we report, this risk is increased by performing an obstetric surgery.…”

The significance of C-reactive protein for the prediction of net-adverse clinical outcome in patients with acute pulmonary embolism

“…In our investigation the 30-day mortality was three times higher in patients with provoked pulmonary tromboembolism than with spontaneous one, while NACO was twice higher, and the difference for both variables was highly significant. Gjonbrataj et al 22 conducted study in Korea and established that the 30-day mortality was 2-fold higher in patients with provoked PE than in those with unprovoked PE, although that difference was not statistically significant.…”

Features of in-hospital clinical course of pulmonary embolism in patients of different age groups

“…Кроме того, в дан- ном исследовании показано, что в группе больных молодого возраста преобладают женщины, а после 50 лет распространенность ТЭЛА у обоих полов одинакова [11], в то время как в настоящем исследовании установлено, что чем старше пациенты, тем большее количество женщин наблюдалось в группе. В работе, проведенной на корейской популяции, преобладали женщины со средним возрастом 64,8 года [12]. В другом исследовании установлено, что пациенты в возрасте >76 лет имели более высокий процент субмассивной ТЭЛА (91,1%; р=0,0006), дисфункции ПЖ (91,1%; р=0,0001), повышенного систолического давления в ЛА (42,64±16,70 мм рт.ст., р=0,00004) и повышенного уровня сердечного тропонина I (0,22±0,40 нг/мл, р=0,004) по сравнению с пациентами <76 лет.…”