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Is a complete blood cell count useful in determining the prognosis of pulmonary embolism?

Ist ein komplettes Blutbild bei der Beurteilung der Prognose einer Pulmonalembolie nützlich?

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Summary

Background

Pulmonary embolism (PE) is the third cardiovascular cause of hospital admission, following acute coronary syndrome and stroke. Despite high-tech diagnostic methods and new treatment modalities, PEs continue to have a high mortality rate within the first 3 months. This study was designed to assess the additional prognostic value of a complete blood cell count, renal function markers, C-reactive protein, and simplified pulmonary embolism severity index (sPESI) scoring system in PE 100-day mortality.

Materials and methods

The study retrospectively enrolled 208 consecutive patients who were hospitalized with the diagnosis of an acute PE. The patients’ demographic characteristics and clinical and laboratory parameters were recorded from the hospital electronic database and patient’s case notes. The primary end point of the study was an adverse 100-day outcome, defined as death from any cause.

Results

The all-cause mortality in the first 100 days was 14.42 %. The mean age was 57.87 ± 18.17 (range: 16–93) years. We included 79 (38 %) male and 129 (62 %) female individuals. Red cell distribution width (RDW) and sPESI were found to be statistically significant predictors of PE mortality by multivariate regression analysis. On multivariate regression analysis, RDW was associated with a 4.08-fold (95 % confidence interval: 1.229–13.335, P = 0.021) increase in PE mortality.

Conclusion

The results of this study demonstrated that RDW and sPESI may be a useful guide in predicting 100-day mortality. The elevated RDW may alert physicians to possible poor prognosis.

Zusammenfassung

Grundlagen

Die Pulmonalembolie (PE) ist nach dem akuten Koronarsyndrom und dem Schlaganfall der dritthäufigste kardiovaskuläre Grund für eine Aufnahme ins Spital. Trotz hochtechnisierter Diagnostik und neuen Behandlungsmethoden haben Patienten mit einer PE noch immer eine hohe Mortalität innerhalb der ersten 3 Monate nach dem Ereignis. Die vorliegende Studie hat es sich zum Ziel gemacht, den zusätzlichen prognostischen Wert eines kompletten Blutbilds (kBB), des CRPs, von Markern der Nierenfunktion und von einem vereinfachten PE-Schweregrad Index (sPESI) in Bezug auf die Mortalität innerhalb der ersten 100 Tagen nach einer PE zu erheben.

Material und Methoden

Die Studie erfasste retrospektiv 208 konsekutive Patienten (79 (38 %) Männer, 129 (62 %) Frauen), die wegen der Diagnose einer akuten PE hospitalisiert worden waren. Die demographischen Charakteristika und Laborparameter wurden aus den elektronisch gespeicherten Spitalsdaten und individuellen Krankengeschichten erhoben. Der primäre Endpunkt der Studie war Tod jeder Ursache innerhalb der ersten 100 Tage.

Ergebnisse

Die Gesamtmortalität betrug 14,42 % innerhalb der ersten 100 Tage. Das mittlere Alter der Patienten lag bei 57,87 ± 18,17 (range: 16–93) Jahren. Die multivariate Regressionsanalyse ergab, dass die Verteilung der Erythrozytenbreite (RDW) und der erhobenen sPESI statistisch signifikante Prädiktoren der Mortalität nach PE waren. In dieser Analyse war die RDW mit einem 4,08 fachen (95 % CI: 1,229–13,335, P = 0,021) Anstieg der Mortalität nach PE verbunden.

Schlussfolgerungen

Die Ergebnisse dieser Studie zeigen, dass die RDW und sPESI im Bezug auf die Beurteilung der Prognose nach PE nützlich sein können. Erhöhte RDW könnten den Arzt auf eine möglicherweise schlechtere Prognose hinweisen.

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Authors and Affiliations

  1. The Department of Pulmonology, Dicle University Medical Faculty, Diyarbakir, Turkey

    Hadice Selimoglu Sen,  Ozlem Abakay,  Abdullah Cetin Tanrikulu,  Cengizhan Sezgi,  Mahsuk Taylan,  Abdurrahman Abakay,  Halide Kaya &  Abdurrahman Senyigit

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  1. Hadice Selimoglu Sen
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Correspondence to Hadice Selimoglu Sen.

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Sen, H., Abakay, O., Tanrikulu, A. et al. Is a complete blood cell count useful in determining the prognosis of pulmonary embolism?. Wien Klin Wochenschr 126, 347–354 (2014). https://doi.org/10.1007/s00508-014-0537-1

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