[Prognostic analysis of acute pulmonary thromboembolism with newly diagnosed atrial fibrillation]

Abstract

Objective: To analyze the clinical characteristics and to explore the prognostic factors of acute pulmonary embolism(APE) with newly diagnosed atrial fibrillation(AF). Methods: The medical records of inpatients with APE discharged from Beijing Anzhen Hospital between January 1, 2008, and December 31, 2021 were retrospectively reviewed. The clinical symptoms, complications, laboratory results, echocardiographic parameters, simplified pulmonary embolism severity index (sPESI) and adverse in-hospital outcome were compared between the newly diagnosed AF group and the sinus rhythm group. Logistic regression analysis was used to evaluate the risk factors of adverse in-hospital outcome with APE. Results: Fifty-one patients were included in newly diagnosed AF group and 102 cases in the sinus rhythm group. The patients in newly diagnosed AF group had greater sPESI scores, higher proportion of sPESI≥2 scores, higher incidence of adverse in-hospital outcome as well as longer hospital stay days. Newly diagnosed AF and sPESI≥2 scores were independent predictors affecting adverse in-hospital outcome. The area under ROC curve in newly diagnosed AF combined with sPESI≥2 scores was largest. Conclusions: The APE patients with newly diagnosed AF were more severely ill and prone to in-hospital adverse outcome. Newly diagnosed AF was an independent predictor affecting adverse in-hospital outcome. sPESI≥2 combined with newly diagnosed AF scores had a high predictive value for the occurrence of in-hospital adverse outcome.