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Pleural effusions as a predictive parameter for poor prognosis for patients with acute pulmonary thromboembolism

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Abstract

The incidence, characteristics of pleural effusions due to pulmonary thromboembolism (PTE) have been reported previously. However, the impact of pleural effusions on the prognosis of acute PTE patients and the involved influencing factors remain unclear. A total of 518 consecutive PTE patients were enrolled in Beijing Chao-Yang Hospital from January 2009 to April 2014. The diagnosis was confirmed with Spiral computer tomography pulmonary angiography or/and high-probability ventilation and perfusion scans. All patients finished one-year clinical follow-up. Among 518 patients with acute PTE, pleural effusions were found in 120 patients (23.2 %). No strictly tight association between side of pleural effusions and location of thrombus was observed. The diagnosis time between patients of PTE with pleural effusions and without pleural effusions had no statistically significant difference. During the 3-month follow-up, the all-cause mortality of PTE patients with pleural effusions was significantly higher than those without pleural effusions [10/120 (8.3 %) vs. 8/398 (2.0 %)]. During the 1-year follow-up, analysis of survival also showed that all-cause mortality was significantly higher in PTE patients with pleural effusions than those without pleural effusions. In both univariate Cox-regression analysis [P < 0.001, HR 3.044, 95 % CI (1.647, 5.625)] and multivariate Cox-regression analysis [P < 0.05, HR 2.040, 95 % CI (1.038, 4.009)] pleural effusions showed to be risk factor of poor prognosis. Pleural effusions in patients with acute PTE were significantly correlated with higher mortality. Pleural effusions in acute PTE patients might be used as a predictive parameter for prognosis.

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Abbreviations

PTE:

Pulmonary thromboembolism

CT:

Computer tomography

VTE:

Venous thromboembolism

DVT:

Deep vein thrombosis

CTPA:

Computed tomography pulmonary angiography

HPVQ:

High-probability ventilation and perfusion scan

BMI:

Body mass index

ANOVA:

Analysis of variance

HR:

Hazard ratios

95 % CIs:

95 % confidence intervals

HRCT:

High-resolution computed tomography

PE:

Pleural effusions

INR:

International normalized ratio

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Acknowledgments

We are very grateful to members of department of Respiratory Medicine of Beijing Chao-Yang Hospital and thank Wenyao Wang (National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences) for the help in data analysis.

Funding/support

This study was supported by Projects of National Science & Technology Pillar Program of China during the 12th Five-year Plan Period. (Grant Nos. 2011BAI11B17, 2012BAI05B01, 2013BAI09B00), Beijing Youth Star of Science and Technology Program (No. 2007B037); The capital health research and development of special fund (2011-1004-03); National Department of Public Benefit Research Foundation by Ministry of Health P. R. China (No. 201302008), Beijing Natural Science Foundation (7152062), National Natural Science Foundation of China (No. 81570049), High Technical Training Project of Beijing Municipal Health System (No. 2013–2016).

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Authors and Affiliations

  1. Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China

    Xia Zhou, Zhenguo Zhai, Yunxia Zhang, Ran Miao & Yuanhua Yang

  2. Beijing An-Zhen Hospital, Capital Medical University, Beijing, People’s Republic of China

    Zhu Zhang

  3. China-Japan Friendship Hospital, Yinghua Dongjie, Hepingli, Beijing, 100029, People’s Republic of China

    Zhenguo Zhai, Wanmu Xie, Jun Wan & Chen Wang

  4. Department of Respiratory Medicine, Capital Medical University, Beijing, People’s Republic of China

    Zhenguo Zhai, Yunxia Zhang, Wanmu Xie, Jun Wan & Chen Wang

  5. National Clinical Research Center of Respiratory Medicine, Beijing, People’s Republic of China

    Chen Wang

  6. Department of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China

    Zhenguo Zhai

Authors
  1. Xia Zhou
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  2. Zhu Zhang
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  3. Zhenguo Zhai
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  4. Yunxia Zhang
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  5. Ran Miao
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  6. Yuanhua Yang
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  7. Wanmu Xie
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  8. Jun Wan
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  9. Chen Wang
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Corresponding author

Correspondence to Zhenguo Zhai.

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None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript.

Appendix

Appendix

See Fig. 3.

Fig. 3
figure 3

Side of pleural effusion and location of thrombus. The relationship between location of pleural effusion and location of thrombus. No tight association between side of pleural effusion and location of thrombus was observed

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Cite this article

Zhou, X., Zhang, Z., Zhai, Z. et al. Pleural effusions as a predictive parameter for poor prognosis for patients with acute pulmonary thromboembolism. J Thromb Thrombolysis 42, 432–440 (2016). https://doi.org/10.1007/s11239-016-1371-2

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  • DOI: https://doi.org/10.1007/s11239-016-1371-2

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