Association between syncope and adverse prognosis in patients with acute pulmonary embolism

Abstract

Objective To investigate the clinical features of syncope in patients with acute pulmonary embolism(APE), and to analyze the relationship between syncope and risk stratification of acute pulmonary embolism and in-hospital mortality. Methods A retrospective study of 401 patients who were diagnosed with APE from January 2012 to October 2017 in our hospital. They were divided into two groups: patients who presented with syncope (n=58) and those without syncope (n=343). The clinical data, treatment and in-hospital mortality of two groups were analyzed by single factor analysis and multivariate Logistics regression analysis. Results Among 401 subjects with APE, there were 196 males and 205 females, aged 15 to 89 years, with an average age of (58.5±15.6) years. There were significant differences in admission systolic blood pressure 100 bmp/min, troponin Ⅰ>0.04 μg/L, brain natriuretic peptide>100 pg/ml, right ventricular dilation, moderate to severe pulmonary hypertension, pulmonary artery trunk and/or right and/or left main pulmonary artery embolism, lower extremity venous dilatation and receive systemic thrombolysis between two groups (all P 0.05). On multivariate analysis, admission systolic blood pressure 0.04 μg/L, moderate to severe pulmonary hypertension and pulmonary artery trunk and/or right and/or left main pulmonary artery embolism were significantly higher among those with syncope (all P 100 bpm, thrombus of lower extremity venous, lower extremity venous dilatation, the proportion of neutrophils and D-dimer. Conclusions More APE patients with syncope involved pulmonary artery trunk or right and/or left main pulmonary artery embolism, moderate to severe pulmonary hypertension, admission systolic blood pressure 0.04 μg/L. Syncope might be related to intermediate-high-risk and high risk APE, but there is no significant association with high in-hospital mortality. Key words: Acute pulmonary embolism; Syncope; Hypotension; Risk stratification; Hospital mortality