Clinical characteristics and anticoagulation patterns of patients with acute pulmonary thromboembolism and hemoptysis.

IF 2.2 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pulmonary Circulation Pub Date : 2024-07-31 eCollection Date: 2024-07-01 DOI:10.1002/pul2.12422
Yiyao Li, Peijun Xue, Ting Zhang, Min Peng, Xuefeng Sun, Juhong Shi
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Abstract

Hemoptysis is a frequently encountered manifestation in cases of acute pulmonary thromboembolism (PTE), significantly impacting clinical decision-making. Despite its clinical relevance, studies focusing on patients with acute PTE and hemoptysis are notably scarce. In this retrospective study, we examined data from hospitalized patients with acute PTE at Peking Union Medical College Hospital (PUMCH) between January 2012 and October 2020. Among the 896 patients analyzed, 105 (11.7%) presented with hemoptysis. Patients with hemoptysis were younger, had higher RRs, and frequently reported chest pain, predominantly showing a negative sPESI score. A significant association with autoimmune diseases was observed (39.0% vs. 16.1%; p < 0.001), along with higher occurrences of pulmonary infections (29.5%), lung cancer (21.0%), and chronic heart failure (16.2%). Hemoptysis in PTE is multifactorial; 51.4% of cases were PTE-related, with 85.2% experiencing mild hemoptysis. Among patients with disease-related hemoptysis (13.3%), 90.9% with massive hemoptysis had underlying diseases, predominantly lung cancer. In 35.2% of cases, the cause of hemoptysis remained undetermined, with vasculitis accounting for 29.7%. Anticoagulation strategies varied with the severity of hemoptysis; 82.9% with mild and only 27.3% with massive hemoptysis received therapeutic-dose anticoagulation. Multivariate analysis identified massive hemoptysis as the most significant determinant of anticoagulation decisions. Patients with massive hemoptysis had the poorest outcomes, with an in-hospital mortality rate of 36.4% and 72.7% receiving reduced or no anticoagulation.

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急性肺血栓栓塞症和咯血患者的临床特征和抗凝模式。
咯血是急性肺血栓栓塞症(PTE)病例中经常出现的一种表现,对临床决策产生重大影响。尽管其临床意义重大,但针对急性 PTE 和咯血患者的研究却很少。在这项回顾性研究中,我们研究了北京协和医院(PUMCH)2012 年 1 月至 2020 年 10 月期间急性 PTE 住院患者的数据。在分析的 896 名患者中,有 105 人(11.7%)出现咯血。咯血患者年龄较轻,RRs较高,经常报告胸痛,主要表现为sPESI评分为阴性。据观察,咯血与自身免疫性疾病有明显的关联(39.0% 对 16.1%;P
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来源期刊
Pulmonary Circulation
Pulmonary Circulation Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.20
自引率
11.50%
发文量
153
审稿时长
15 weeks
期刊介绍: Pulmonary Circulation''s main goal is to encourage basic, translational, and clinical research by investigators, physician-scientists, and clinicans, in the hope of increasing survival rates for pulmonary hypertension and other pulmonary vascular diseases worldwide, and developing new therapeutic approaches for the diseases. Freely available online, Pulmonary Circulation allows diverse knowledge of research, techniques, and case studies to reach a wide readership of specialists in order to improve patient care and treatment outcomes.
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