Relation of anemia with renal function on prognosis and disease severity in patients with acute pulmonary embolism

Ö. Demir
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Abstract

Background: In-hospital mortality for patients presenting with acute pulmonary embolism (PE) has been reported to be up to 7 times higher for patients with decreased estimated glomerular filtration rate (eGFR). Cardiopulmonary diseases and anemia are other comorbid conditions that are suggested to be prognostic parameters in acute PE. The severity of anemia in acute PE was associated with worsening survival. We aimed to investigate the effect of anemia on association of renal function with prognosis and disease severity in patients with acute PE. Patients/Methods: The retrospective study enrolled 112 consecutive patients presenting with objectively confirmed acute PE. Demographic, clinical data, comorbidities and laboratory values were recorded. GFR were estimated using the chronic kidney disease (CKD)-EPI equations. Simplified pulmonary embolism severity index (sPESI) was calculated for all patients and severe form of the disease was defined as sPESI ≥1. In hospital mortality was primer outcome. Results: In univariate analyses, age, eGFR, anemia and chronic lung disease were found to be significantly associated with in-hospital mortality and disease severity. Only age and eGFR were found to be significant prognostic factors for early mortality [1.13(1.03-1.24); p=0.007 and 0.95(0.91 0.98); p=0.007 respectively]. Conclusion: Estimated GFR is independently associated with a more severe form of the disease and increased risk of early mortality rates within 30 days in acute pulmonary embolism independent of anemia presence.
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急性肺栓塞患者贫血与肾功能与预后及病情严重程度的关系
背景:据报道,急性肺栓塞(PE)患者的住院死亡率比肾小球滤过率(eGFR)降低的患者高7倍。心肺疾病和贫血是其他合并症,被认为是急性PE的预后参数。急性PE患者贫血的严重程度与生存恶化有关。我们的目的是探讨贫血对急性PE患者肾功能与预后和疾病严重程度的关系的影响。患者/方法:回顾性研究纳入了112例客观确诊的急性PE患者。记录人口统计学、临床资料、合并症和实验室值。使用慢性肾脏疾病(CKD)-EPI方程估计GFR。计算所有患者的简化肺栓塞严重程度指数(sPESI),以sPESI≥1为疾病的严重形式。住院死亡率是初步结局。结果:在单变量分析中,年龄、eGFR、贫血和慢性肺部疾病与住院死亡率和疾病严重程度显著相关。只有年龄和eGFR被发现是早期死亡的重要预后因素[1.13(1.03-1.24);P =0.007和0.95(0.91 0.98);分别p = 0.007)。结论:估计的GFR与更严重的疾病形式和急性肺栓塞患者30天内早期死亡率增加的风险独立相关,而不依赖于贫血的存在。
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