Abstract
Objective To explore the predictive value of mean platelet volume (MPV) and plasma N-terminal probrain natriuretic peptide (NT-ProBNP) combined with a simplified Geneva scale for the prognosis of acute pulmonary embolism (APE). Methods The clinical data of 68 patients with APE admitted to our hospital from October 2017 to October 2019 were collected. According to the prognosis, the patients were divided into a good prognosis group (n = 45) and a poor prognosis group (n = 23). The clinical data, laboratory clinical indexes, and simplified Geneva scale scores were recorded for the two groups. The risk factors of poor prognosis were analyzed by binary multivariate logistic regression analysis; the predictive ability of each index on the prognosis of patients with APE was analyzed by the ROC curve. Results The incidences of deep vein thrombosis, diabetes, and hyperlipidemia in the poor prognosis group were higher than those in the good prognosis group (P < 0.05). PLT, platelet distribution width (PDW), MPV, and plasma NT-ProBNP in the poor prognosis group were higher than those in the good prognosis group (P < 0.05). The simplified Geneva scale score of the poor prognosis group was higher than that of the good prognosis group (P < 0.05). PDW, MPV, plasma NT-ProBNP, and simplified Geneva scale were all independent risk factors for the poor prognosis of APE patients (P < 0.05). The AUC of MPV in predicting the prognosis of APE patients was 0.818 (95% CI: 0.712–0.925). When the optimal cutoff value was 0.571, the sensitivity was 77.1%, and the specificity was 80.0%. The AUC of plasma NT-ProBNP in predicting the prognosis of APE patients was 0.762 (95% CI: 0.634–0.891). When the optimal cutoff value was 0.475, the sensitivity was 71.5%, and the specificity was 76.0%. The AUC of the simplified Geneva scale in predicting the prognosis of APE patients was 0.749 (95% CI: 0.618–0.879). When the optimal cutoff value was 0.469, the sensitivity was 82.9%, and the specificity was 64.0%. The AUC of MPV and plasma NT-ProBNP combined with the simplified Geneva scale in predicting the prognosis of APE patients was 0.907 (95% CI: 0.826–0.988). When the optimal cutoff value was 0.726, the sensitivity was 88.6%, and the specificity was 84.0%. Conclusion MPV, plasma NT-ProBNP, and simplified Geneva scale have a certain predictive value for the prognosis of APE. Compared with a single index, the combination of the three indexes has a significant improvement in predicting the prognosis of APE and has better clinical value.
Highlights
Acute pulmonary embolism (APE) refers to a variety of emboli that block the pulmonary artery and its branches, leading to pulmonary circulation disorders, resulting in a variety of pathological and physiological changes
APE has become the third-largest cardiovascular disease in clinical practice, second only to coronary heart disease and hypertension, which seriously endangers the quality of life and health of patients [4]. erefore, it is of great significance to evaluate the prognosis of APE patients as soon as possible and adopt scientific and reasonable countermeasures to deal with the disease
Comparison of Clinical Data between the Two Groups. ere was no significant difference between the two groups in age, gender, body mass index (BMI), smoking history, drinking history, surgery or trauma, tumor, idiopathic factors, and other primary diseases such as hypertension, coronary heart disease, and chronic kidney disease (P > 0.05). e incidences of deep vein thrombosis, diabetes, and hyperlipidemia in the poor prognosis group were higher than those in the good prognosis group (P < 0.05; Table 2)
Summary
Acute pulmonary embolism (APE) refers to a variety of emboli that block the pulmonary artery and its branches, leading to pulmonary circulation disorders, resulting in a variety of pathological and physiological changes. APE is mainly manifested as sudden chest pain, dyspnea, hemoptysis, and other manifestations. It has a rapid onset and rapid development and has the characteristics of low specificity and poor prognosis [1, 2]. The number of Evidence-Based Complementary and Alternative Medicine patients suffering from APE has been increasing. APE has become the third-largest cardiovascular disease in clinical practice, second only to coronary heart disease and hypertension, which seriously endangers the quality of life and health of patients [4]. Erefore, it is of great significance to evaluate the prognosis of APE patients as soon as possible and adopt scientific and reasonable countermeasures to deal with the disease APE has become the third-largest cardiovascular disease in clinical practice, second only to coronary heart disease and hypertension, which seriously endangers the quality of life and health of patients [4]. erefore, it is of great significance to evaluate the prognosis of APE patients as soon as possible and adopt scientific and reasonable countermeasures to deal with the disease
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