The long-term prognosis and influencing factors of acute pulmonary thromboembolism in the elderly: analysis of 627 cases
  
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DOI:10.11915/j.issn.1671-5403.2015.12.204
Key words:pulmonary embolism  aged  prognosis
Author NameAffiliationE-mail
ZHANG Shuai1,2,3, ZHAI Zhen-Guo1,2,3,4*, YANG Yuan-Hua4, GONG Juan-Ni4, XIE Wan-Mu1,2,3, KUANG Tu-Guang4, WANG Chen1,2,3* 1Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
2National Clinical Research Center for Respiratory Diseases, Beijing 100730, China
3Faculty of Respiratory Medicine, Capital Medical University, Beijing 100069, China
4Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing Chaoyang Hospital of Capital Medical University, Beijing 100020, China 
cyh-birm@263.net; 翟振国, E-mail: zhaizhenguo2011@126.com 
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Abstract:
      Objective To investigate the clinical features, prognosis and factors influencing survival for the elderly patients with pulmonary thromboembolism (PTE). Methods A total of 627 patients with identified acute PTE admitted in Beijing Chaoyang Hospital from January 2006 to March 2011 were enrolled in this study. They were divided into the ≥65 year-old group (n=309) and the <65 year-old group (n=318). Their clinical data were compared to analyze the influencing factors of prognosis and survival. Results There was no significant difference in recurrence of venous thromboembolism (VTE) between the two groups (P=0.157). But the older group had obviously higher mortality than the younger one (P<0.001). The analysis on cause of death indicated that there were more patients died of other definite causes (including severe infection, respiratory failure, renal failure, multiple organ failure, and so on) in the ≥65 year-old group than those in the younger group (P=0.006). Univariate Cox analysis showed that age, body mass index (BMI), complication of malignant tumor, systolic pulmonary artery pressure (SPAP) >50mmHg, surgery secondary to PTE within 2 months, and long-term anticoagulant therapy were correlated with the occurrence of death. But further multivariate Cox analysis suggested that only age, malignant tumor, SPAP >50mmHg, surgery within 2 months after PTE, and long-term anticoagulant therapy be high risk factors for death. Conclusion The elderly PTE patients have poor long-term prognosis due to their complications of chronic comorbidities. Physicians should pay attention to this, and emphasize regular treatment for their complications in addition to the standard diagnosis and treatment of PTE.
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