Clinical characteristics and mortality predictors among very old patients with pulmonary thromboembolism: a multicenter study report

作者全名："Zhou, Xia; Yang, Yuanhua; Zhai, Zhenguo; Wang, Dingyi; Lei, Jieping; Xu, Xiaomao; Ji, Yingqun; Yi, Qun; Chen, Hong; Hu, Xiaoyun; Liu, Zhihong; Mao, Yimin; Zhang, Jie; Shi, Juhong; Zhang, Zhu; Wu, Sinan; Gao, Qian; Tao, Xincao; Xie, Wanmu; Wan, Jun; Zhang, Yunxia; Zhang, Shuai; Zhen, Kaiyuan; Zhang, Zhonghe; Fang, Baomin; Wang, Chen; Li, Jifeng; Yang, He; Wang, Lan; Zhou, Haixia; Wang, Maoyun; Wang, Xiaohui; Luo, Qin; Fan, Junping; An, Jun; Zeng, Mian; Li, Xia; Zhu, Ling; Liu, Yi; Ying, Kejing; Ma, Guofeng; Yan, Chao; Dong, Lixia; Zhou, Wei; Bai, Chong; Zhang, Wei; Wang, Liangxing; Xie, Yupeng; Huang, Xiaoying; Qiu, Chen; Li, Yazhen; Fu, Yingyun; Liu, Shengguo; Li, Shengqing; Zhang, Jian; Han, Xinpeng; Xu, Qixia; Li, Xiaoqing; Pang, Yingying; Gong, Beilei; Huang, Ping; Chen, Yanwei; Chen, Jiming; Shi, Guochao; Ding, Yongjie; Cheng, Zhaozhong; Tong, Li; Ma, Zhuang; Liu, Lei; Jiang, Luning; Liang, Zhijun; Deng, Chaosheng; Yang, Minxia; Wu, Dawen; Zhang, Shudong; Kang, Lijun; Yu, Fangfei; Chen, Xuewei; Han, Dan; Shen, Shasha; Sun, Guohua; Hou, Yutao; Liu, Baoliang; Fan, Xiaohong; Zhang, Ping; Xu, Ruhong; Wang, Zaiyi; Yan, Cunzi; Yu, Chunxiao; Lu, Zhenfang; Hua, Jing; Xu, Zhenyang; Zhang, Hongxia; Wang, Jinxiang; Yang, Xiaohong; Chen, Ying; Tang, Yongjun; Yang, Wei; Zhang, Nuofu; Duan, Linli; Qing, Simin; Liu, Chunli; Jiang, Lian; Zhao, Hongda; Liu, Chengying; Yuan, Yadong; Gong, Xiaowei; Zhang, Xinhong; Zhang, Chunyang; Xia, Shuyue; Jia, Hui; Liu, Yunxia; Zhang, Dongmei; Ma, Yuntian; Guo, Lu; Zhang, Jing; Han, Lina; Bai, Xiaomin; Yang, Guoru; Yu, Guohua; Yang, Ruian; Fan, Jingyuan; Zhang, Aizhen; Jiang, Rui; Li, Xueshuang; Wu, Yuzhi; Han, Jun; Yang, Jingping; Xu, Xiyuan; Bu, Baoying; Cui, Chaobo; Wang, Ning; Zhang, Yonghai; Duo, Jie; Tuo, Yajun; Ding, Yipeng; Xu, Heping; Sun, Dingwei; Zhang, Xiangyan; Liu, Weijia; Wang, Hongyang; Wang, Yuan; Fu, Aishuang; Huang, Songping; Xu, Qinghua; Chai, Wenshu; Li, Jing; Ye, Yanping; Hu, Wei; Chen, Jin; Liu, Bo; Suo, Lijun; Guo, Changcheng; Wang, Ping; Liu, Jinming; Zhao, Qinhua; Kang, Le; Xu, Jianying; Zhao, Lifen; Cheng, Mengyu; Duan, Wei; Wu, Qi; Li, Li; He, Xiuqing; Li, Yueyue; Chen, Gang; Zhao, Yunxia; Liu, Zixiao; Xia, Guoguang; Li, Tianshui; Chen, Nan; Liu, Xiaoyang; Bian, Tao; Wu, Yan; Yang, Huiqin; Tang, Xiaoli; Zhang, Yiwen; Jin, Faguang; Chen, Yanli; Li, Yanyan; Lao, Miaochan; Dong, Liang; Zhu, Guangfa; Zhang, Wenmei; Chen, Liangan; Liang, Zhixin; Cui, Liping; Xia, Cenfeng; Zhang, Jin; Zhang, Peng; Guo, Lianxiang; Niu, Sha; Yu, Sichong; Liu, Guangjie; Wang, Xinmao; Lv, Yanhua; Liang, Zhenyu; Cai, Shaoxi; Yang, Shuang; Zhang, Xinyi; Kuang, Jiulong; Ding, Yanyan; Zhang, Yongxiang; Guo, Xuejun; Wang, Yanmin; Wang, Jialie; Hu, Ruimin; Ma, Lin; Gao, Yuan; Zheng, Rui; Shi, Zhihong; Li, Hong; Zhang, Yingqi; Su, Guanli; Qin, Zhiqiang; Chen, Guirong; Chen, Xisheng; Niu, Zhiwei; Jiang, Jinjun; Chen, Shujing; Zhang, Tiantuo; Li, Hongtao; Zhu, Jiaxin; Zhou, Yuqi; Yang, Yinlou; Cheng, Jiangtao; Sun, Jie; Jiang, Yanwen; Liu, Jianhua; Wang, Yujun; Yin, Ju; Chen, Lanqin; Yang, Min; Jiang, Ping; Liu, Hongbo; Zhen, Guohua; Zhang, Kan; Wan, Yixin; Tao, Hongyan"

作者地址："[Zhou, Xia] Capital Med Univ, Dept Nucl Med, Shijingshan Teaching Hosp, Beijing, Peoples R China; [Yang, Yuanhua] Capital Med Univ, Beijing Chao Yang Hosp, Beijing Inst Resp Med, Dept Resp & Crit Care Med, Beijing, Peoples R China; [Zhai, Zhenguo; Wang, Dingyi; Lei, Jieping; Zhang, Zhu; Wu, Sinan; Gao, Qian; Tao, Xincao; Xie, Wanmu; Wan, Jun; Zhang, Yunxia; Zhang, Shuai; Zhen, Kaiyuan; Wang, Chen] Chinese Acad Med Sci, China Japan Friendship Hosp,Inst Resp Med, Natl Ctr Resp Med,Natl Clin Res Ctr Resp Dis, Dept Pulm & Crit Care Med,Ctr Resp Med, Beijing, Peoples R China; [Wang, Dingyi; Lei, Jieping; Zhang, Zhu; Wu, Sinan; Gao, Qian; Tao, Xincao; Xie, Wanmu; Wan, Jun] China Japan Friendship Hosp, Inst Clin Med Sci, Data & Project Management Unit, Beijing, Peoples R China; [Xu, Xiaomao; Fang, Baomin] Beijing Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China; [Ji, Yingqun; Zhang, Zhonghe] First Affiliated Hosp Dalian Med Univ, Dept Pathol, Dalian 116011, Peoples R China; [Yi, Qun] Sichuan Univ, West China Hosp, West China Sch Med, Dept Resp & Crit Care Med, Chengdu, Peoples R China; [Chen, Hong] First Affiliated Hosp Chongqing Med Univ, Dept Crit Care Med, Chongqing 400016, Peoples R China; [Hu, Xiaoyun] First Hosp Shanxi Med Univ, Dept Pulm & Crit Care Med, Taiyuan 030001, Peoples R China; [Liu, Zhihong] Chinese Acad Med Sci, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Beijing, Peoples R China; [Mao, Yimin] Henan Univ Chinese Med, Affiliated Hosp 1, Dept Resp & Crit Care Med, Zhengzhou, Peoples R China; [Zhang, Jie] Second Hosp Jilin Univ, Dept Pulm & Crit Care Med, Changchun, Jilin, Peoples R China; [Shi, Juhong] Peking Union Med Coll Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China; [Zhang, Zhu] Chinese Acad Med Sci & Peking Union Med Coll, Grad Sch, Peking Union Med Coll, Beijing 100730, Peoples R China; [Zhen, Kaiyuan] Peking Univ China Japan Friendship Sch Clin Med, Beijing, Peoples R China; [Wang, Chen] Chinese Acad Med Sci Peking Union Med Coll, Peking Union Med Coll Hosp, Beijing, Peoples R China; [Wang, Chen] Capital Med Univ, Dept Resp Med, Beijing, Peoples R China"

通信作者："Yang, YH (通讯作者)，Capital Med Univ, Beijing Chao Yang Hosp, Beijing Inst Resp Med, Dept Resp & Crit Care Med, Beijing, Peoples R China.; Zhai, ZG (通讯作者)，Chinese Acad Med Sci, China Japan Friendship Hosp,Inst Resp Med, Natl Ctr Resp Med,Natl Clin Res Ctr Resp Dis, Dept Pulm & Crit Care Med,Ctr Resp Med, Beijing, Peoples R China."

来源：BMC PULMONARY MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001140902400003

JCR分区：Q2

影响因子：3.1

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Pulmonary thromboembolism; Old; Mortality

摘要："Background Clinical characteristics of patients with pulmonary thromboembolism have been described in previous studies. Although very old patients with pulmonary thromboembolism are a special group based on comorbidities and age, they do not receive special attention.Objective This study aims to explore the clinical characteristics and mortality predictors among very old patients with pulmonary thromboembolism in a relatively large population.Design and participants The study included a total of 7438 patients from a national, multicenter, registry study, the China pUlmonary thromboembolism REgistry Study (CURES). Consecutive patients with acute pulmonary thromboembolism were enrolled and were divided into three groups. Comparisons were performed between these three groups in terms of clinical characteristics, comorbidities and in-hospital prognosis. Mortality predictors were analyzed in very old patients with pulmonary embolism.Key results In 7,438 patients with acute pulmonary thromboembolism, 609 patients aged equal to or greater than 80 years (male 354 (58.1%)). There were 2743 patients aged between 65 and 79 years (male 1313 (48%)) and 4095 patients aged younger than 65 years (male 2272 (55.5%)). Patients with advanced age had significantly more comorbidities and worse condition, however, some predisposing factors were more obvious in younger patients with pulmonary thromboembolism. PaO2 < 60 mmHg, eGFR < 60 mL/min/1.73m2, malignancy, anticoagulation as first therapy were mortality predictors for all-cause death in very old patients with pulmonary thromboembolism. The analysis found that younger patients were more likely to have chest pain, hemoptysis (the difference was statistically significant) and dyspnea triad.Conclusion In very old population diagnosed with pulmonary thromboembolism, worse laboratory results, atypical symptoms and physical signs were common. Mortality was very high and comorbid conditions were their features compared to younger patients. PaO2 < 60 mmHg, eGFR < 60 mL/min/1.73m2 and malignancy were positive mortality predictors for all-cause death in very old patients with pulmonary thromboembolism while anticoagulation as first therapy was negative mortality predictors."

基金机构："China Key Research Projects of the 12th National Five-Year Development Plan [2011BA11B17]; CAMS Innovation Fund for Medical Sciences (CIFMS) [2018-I2M-1-003]; National Key R&D Program of China [2016YFC0905600, 2016YFC0901104]; National Key Research and Development Program [2023YFC2507200]; National Nature Science Foundation of China [81900047, 62206187]; Beijing Research Ward Demonstration Construction Project [BCRW202110]; Financial Budgeting Project of Beijing Institute of Respiratory Medicine [Ysbz2023003]"

基金资助正文："The study was funded by the China Key Research Projects of the 12th National Five-Year Development Plan (number 2011BA11B17), the CAMS Innovation Fund for Medical Sciences (CIFMS) (number 2018-I2M-1-003), the National Key R & D Program of China (number 2016YFC0905600, 2016YFC0901104), the National Key Research and Development Program (2023YFC2507200), the National Nature Science Foundation of China (81900047, 62206187), Beijing Research Ward Demonstration Construction Project (No. BCRW202110), and the Financial Budgeting Project of Beijing Institute of Respiratory Medicine (Ysbz2023003)"