Clinical features and predictors of in-hospital mortality in patients withacute and chronic pulmonary thromboembolism

Objective The differences in the clinical findings of patients with acute p ulmonary thromboembolism (acute-PTE) and chronic pulmonary thromboembolism (chronic-PTE) were compared, and the association between the clinical findi ngs and prognosis in the two groups was analyzed. Patients This study included 204 patients with PTE, 139 patients with acute -PTE and 65 patients with chronic-PTE. Results There were significant differences between acute-PTE and chronic-PT E in the predisposing factors of post operation (19.4 versus 1.5%, p=0.0003 ), and electrocardiographic signs such as sinus tachycardia (73.7 versus 50 .9%, p=0.007), ST-depression (25.3 versus 9.4%, p=0.03), right ventricular hypertrophy (20.0 versus 47.2%, p=0.0007), and right axis deviation (3.2 ve rsus 22.6%, p=0.0003), Thirty-one of the 139 acute-PTE patients died from P TE, as did 17 of the 65 chronic-PTE patients. The prognosis was poor in pat ients older than 70 years old (p=0.01), with stroke (p=0.008), syncope (p=0 .01), shock (p=0.0006), hypocapnia (Paco(2)less than or equal to 25 torr; p =0.0006) and an elevation in total pulmonary resistance (TPR >1,000 dyne se c.cm(-5) (p=0.02)) in acute-PTE, and in those with syncope (p=0.03), shock (p=0.008), and right ventricular hypertrophy on electrocardiogram (p=0.03) in chronic-PTE, Conclusion The results of this study indicate a relationship between the cl inical features of patients with acute-PTE and chronic-PTE, and the predict ors of in-hospital mortality.