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Comparison of Mortality Risk Factors in Elderly and Young Pulmonary Embolism Patients

DOI: 
10.7727/wimj.2016.147

ABSTRACT

Objective: To determine clinical, radiological, and laboratory findings as well as mortality rates in younger and older patients with pulmonary embolism (PE) and investigate risk factors associated with mortality in elderly patients. 

Materials and Methods: We have evaluated patients with acute PE. Characteristics of patients, presence of deep vein thrombosis, co-morbidities, other risk factors for PE, and mortality rates were recorded. Cases were categorized into elderly (≥ 65 years old) and younger groups and their findings were compared.

 Results: Number of PE patients were 253. 105 (41.5%) of them were older and 148(58.5%) were younger patients. Comparison of groups revealed more frequent presence of co-morbidities, higher simplified pulmonary embolism severity index (sPESI), and mortality rates in older group (All p values <0.001). Elderly cases also had higher right atrial diameters, pulmonary artery systolic pressure levels, and higher frequency of thrombi in proximal pulmonary arterial branches (p values: 0.015, 0.001, and 0.042, respectively). Mortality rate was higher in elderly cases than the youngers [30 (28.6%) vs. 19 (12.8%), p = 0.002]. Multivariate analysis revealed that a sPESI ≥1 (p = 0.034,OR:5.25), increased C-reactive protein (CRP)(p = 0.004,OR:1.26), and blood urea nitrogen (BUN) (p = 0.019,OR:1.04) levels, having operation (p = 0.049,OR:3.92), and presence of co-morbidities (p = 0.016, OR:6.21) were independent risk factors increasing mortality in elderly cases. As to youngers, increased BUN levels (p = 0.010, OR: 1.09) and pulmonary infarction (p = 0.125, OR:1.01) were independent risk factors.

Conclusions: We found high mortality rate in elderly PE patients and sPESI, presence of co-morbidities, surgery, high BUN and CRP levels can be used in prediction of mortality risk in those cases. 

Accepted: 
24 Aug, 2016
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e-Published: 26 Aug, 2016

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