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Comparison of Clinical and Imaging Characteristics and Outcomes between Provoked and Unprovoked Acute Pulmonary Embolism in Koreans

Authors
 Jae-Sun Uhm  ;  Hae-Ok Jung  ;  Chan-Joon Kim  ;  Tae-Hoon Kim  ;  Ho-Joong Youn  ;  Sang Hong Baek  ;  Wook-Sung Chung  ;  Ki Bae Seung 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.27(11) : 1347-1353, 2012 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2012
MeSH
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; C-Reactive Protein/analysis ; Creatinine/blood ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/diagnostic imaging* ; Pulmonary Embolism/mortality ; Recurrence ; Renal Insufficiency/complications ; Republic of Korea ; Risk Factors ; Survival Rate ; Tomography, X-Ray Computed
Keywords
CT Obstruction Index ; Provoked ; Pulmonary Embolism ; Unprovoked
Abstract
This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 ± 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 ± 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
Files in This Item:
T201206172.pdf Download
DOI
23166416
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90925
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