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Clinical predictors and outcomes of pulmonary infarction in patients with central pulmonary embolism.

Authors :
Martinez Manzano JM
Lo KB
Cantu-Martinez O
Nguyen L
Chiang B
Jarrett SA
Tito S
Prendergast A
Planchart Ferretto MA
Roque W
Wattoo A
Azmaiparashvili Z
Benzaquen S
Source :
Expert review of respiratory medicine [Expert Rev Respir Med] 2023 Jul-Dec; Vol. 17 (9), pp. 815-821. Date of Electronic Publication: 2023 Oct 27.
Publication Year :
2023

Abstract

Background: Given the heterogeneity of predisposing factors associated with pulmonary infarction (PI) and the lack of clinically relevant outcomes among patients with acute pulmonary embolism (PE) complicated by PI, further investigation is required.<br />Methods: Retrospective study of patients with central PE in an 11-year period. Data were stratified according to the diagnosis of PI. Multivariable logistic regression analysis was used to analyze factors associated with PI development and determine if PI was associated with severe hypoxemic respiratory failure and mechanical ventilation use.<br />Results: Of 645 patients with central PE, 24% ( n  = 156) had PI. After adjusting for demographics, comorbidities, and clinical features on admission, only age (OR 0.98, CI 0.96-0.99; p  = 0.008) was independently associated with PI. Regarding outcomes, 35% ( n  = 55) had severe hypoxemic respiratory failure, and 19% ( n  = 29) required mechanical ventilation. After adjusting for demographics, PE severity, and right ventricular dysfunction, PI was independently associated with severe hypoxemic respiratory failure (OR 1.78; CI 1.18-2.69, p  = 0.005) and mechanical ventilation (OR 1.92; CI 1.14-3.22, p  = 0.013).<br />Conclusions: Aging is a protective factor against PI. In acute central PE, subjects with PI had higher odds of developing severe hypoxemic respiratory failure and requiring mechanical ventilation.

Details

Language :
English
ISSN :
1747-6356
Volume :
17
Issue :
9
Database :
MEDLINE
Journal :
Expert review of respiratory medicine
Publication Type :
Academic Journal
Accession number :
37750314
Full Text :
https://doi.org/10.1080/17476348.2023.2263359