血液学参数对肺栓塞患者住院死亡率的预测能力

Sevgi zcan, Esra nmez
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摘要

急性肺栓塞(PE)是导致死亡的主要原因之一。全血细胞计数的组成部分表明血栓和/或炎症状态在各种临床条件。在这项研究中,我们旨在评估血液学参数是否可以预测PE患者的住院死亡率。方法回顾性研究2016年至2022年在我院三级中心诊断为急性PE的患者。对入院时获得的血液学参数进行分析。计算PESI评分,进行比较统计和回归分析。结果254例患者中,男性占37.4%。38例(14.9%)患者在医院死亡,构成“非幸存者”组。NLr和RDW是与院内死亡率相关的独立危险因素。我们的研究结果显示血液学参数与PESI风险评分之间存在很强的相关性,NLr的临界值为5.9,敏感性为68.4%,特异性为68.1%;此外,RDW截断值为14.1,预测院内死亡率的敏感性为68.4%,特异性为62.6%。结论:我们目前的研究表明,通过常规血细胞计数分析评估的血液学参数可能作为一种有希望和有用的指标,用于预测急性PE患者的住院死亡率,特别是当与验证的风险评分一起使用时。
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The Predictive Ability of Hematologic Parameters for In-hospital Mortality In Patients Presenting With Pulmonary Embolism
Introduction Acute pulmonary embolism (PE) is one of the leading causes of mortality. Components of complete blood count indicate thrombotic and/or inflammatory status in various clinical conditions. In this study, we aimed to evaluate if hematological parameters could predict in-hospital mortality in patients presenting with PE. Methods Patients hospitalized with a diagnosis of acute PE in our tertiary center between 2016 and 2022 were involved in this retrospective study. Hematologic parameters obtained on admission were analayzed. PESI scores were calculated and comparative statistical and regression analyses were obtained. Results There were 254 patients (37.4% male). Thirty-eight patients (14.9%) were died in-hospital and formed ‘non-survivors’ group. NLr and RDW were found as independent risk factors associated with in-hospital mortality. Our results revealed a strong correlation between hematological parameters and PESI risk score and a cut off value of 5.9 for NLr was associated with 68.4% sensitivity and 68.1% specificity; besides that, cut off value of 14.1 for RDW was associated with 68.4% sensitivity and 62.6% specificity in prediction of in-hospital mortality. Conclusion Our current study showed that hematological parameters, assessed by routine blood count analysis, may serve as a promising and useful marker to foresee in-hospital mortality in patients presenting thru acute PE especially when used additive to validated risk scores.
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