Prognostic value of non-alcoholic fatty liver disease in patients with pulmonary embolism

Nurcan KAÇMAZ KAT, N. Sensoy, M. Kuzeytemiz, Ö. Demir
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Abstract

Objectives: Pulmonary embolism (PE) is an important disease due to its mortality and morbidity-related clinical conditions. Patients with a high risk of death within 30 days are discriminated against with the help of various clinical scores. Non-alcoholic fatty liver disease (NAFLD) has been found to be associated with atherosclerosis. We aimed to investigate the effect of NAFLD on disease severity and early death rate in patients with pulmonary embolism. Methods: This retrospective study includes patients who applied to the emergency department with suspected pulmonary embolism and whose diagnosis was confirmed according to the results of the examination. In addition to confirming the diagnosis of PE, hepatic steatosis was detected and graded by tomographic examination of the liver and spleen. Disease severity was stratified by Simplified Pulmonary Embolism Severity Index (sPESI). Results: A total of 165 patients (105 with sPESI≥1 and 60 with sPESI<1 controls) were included. The rate of mortality was 12% (n=13) in the sPESI≥1 group. The prevalence of NAFLD was 64% and the prevalence of hepatosteatosis was similar according to disease severity and prognosis (67% vs. 58%; P=0.28 and 69% vs. 63%; P=0.77). Besides the effect of disease severity; chronic lung disease (CLD) and chronic kidney disease (CKD) were independently associated with poor prognosis by multivariate analysis [3.71 (1.02-13.46); P=0.04 and 15.89 (2.57-98.35); P=0.003]. Conclusion: No association between disease severity and prognosis was observed with NAFLD in acute PE disease.
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肺栓塞患者非酒精性脂肪肝的预后价值
目的:肺栓塞(PE)是一种重要的疾病,其死亡率和发病率与临床症状有关。在各种临床评分的帮助下,30 天内死亡风险较高的患者被区分开来。研究发现,非酒精性脂肪肝(NAFLD)与动脉粥样硬化有关。我们旨在研究非酒精性脂肪肝对肺栓塞患者疾病严重程度和早期死亡率的影响。研究方法这项回顾性研究包括因疑似肺栓塞到急诊科就诊并根据检查结果确诊的患者。除了确诊肺栓塞外,还通过肝脏和脾脏的断层扫描检测肝脏脂肪变性并进行分级。疾病严重程度按简化肺栓塞严重程度指数(sPESI)进行分层。 结果共纳入 165 例患者(其中 105 例 sPESI≥1 例,60 例 sPESI<1 例)。sPESI≥1组的死亡率为12%(n=13)。非酒精性脂肪肝的患病率为 64%,肝脂肪变性的患病率与疾病严重程度和预后相似(67% 对 58%;P=0.28;69% 对 63%;P=0.77)。除了疾病严重程度的影响外,通过多变量分析,慢性肺部疾病(CLD)和慢性肾脏疾病(CKD)也与预后不良独立相关[3.71(1.02-13.46);P=0.04和15.89(2.57-98.35);P=0.003]。 结论急性 PE 疾病中的非酒精性脂肪肝与疾病严重程度和预后之间没有关联。
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