肺栓塞患者的长期死亡率：单中心登记处结果。
Long-term mortality in patients with pulmonary embolism: results in a single-center registry.
发表日期：2023 Jul
作者：
Johannes Eckelt, Lukas Hobohm, Marie C Merten, Charlotta F Pagel, Ann-Sophie Eggers, Markus H Lerchbaumer, Karl Stangl, Gerd Hasenfuß, Stavros Konstantinides, Irene Schmidtmann, Mareike Lankeit, Matthias Ebner
来源：
Research and Practice in Thrombosis and Haemostasis
摘要：
尽管许多研究已经调查了肺栓塞（PE）后的短期结果，但长期死亡率仍未得到充分研究。为了调查PE患者的长期结果，入选了896名在2005年5月至2017年12月期间被纳入单中心登记处的连续患者。该研究对这些患者进行了长达14年的随访。将观察到的死亡率与一般人口的预期率进行了比较。总随访时间为3908人年（中位数为3.1年）。1年和5年的死亡率分别为 19.7% (95% CI, 17.2%-22.4%) 和 37.1% (95% CI, 33.6%-40.5%)。最常见的死亡原因是癌症（28.5%）、肺栓塞（19.4%）、感染（13.9%）和心血管事件（11.6%）。长期死亡率（30天后）高于一般人口的预期，这一发现在没有癌症的患者中也是一致的（5年标准化死亡比分别为2.77 [95% CI, 2.41-3.16] 和1.80 [95% CI, 1.50-2.14]）。活动性癌症是30天至3年之间死亡的最强风险因素（风险比 [HR] 为6.51；95% CI为4.67-9.08），但与后期死亡无关。>3年后的死亡率受年龄（HR为1.86；95% CI为1.51-2.29每十年）、慢性心力衰竭（HR为1.66；95% CI为1.02-2.70）和贫血（HR为1.62; 95% CI为1.09-2.41）的影响。与一般人群相比，PE患者的死亡风险在随访期间一直较高。头3年内长期死亡的主要因素是癌症。之后，死亡风险受年龄、慢性心力衰竭和贫血的影响。© 2023 The Author(s).
While numerous studies have investigated short-term outcomes after pulmonary embolism (PE), long-term mortality remains insufficiently studied.To investigate long-term outcomes in an unselected cohort of patients with PE.A total of 896 consecutive patients with PE enrolled in a single-center registry between May 2005 and December 2017 were followed up for up to 14 years. The observed mortality rate was compared with the expected rate in the general population.The total follow-up time was 3908 patient-years (median, 3.1 years). The 1- and 5-year mortality rates were 19.7% (95% CI, 17.2%-22.4%) and 37.1% (95% CI, 33.6%-40.5%), respectively. The most frequent causes of death were cancer (28.5%), PE (19.4%), infections (13.9%), and cardiovascular events (11.6%). Late mortality (after >30 days) was more frequent than expected in the general population, a finding that was consistent in patients without cancer (the 5-year standardized mortality ratios were 2.77 [95% CI, 2.41-3.16] and 1.80 [95% CI, 1.50-2.14], respectively). Active cancer was the strongest risk factor for death between 30 days and 3 years (hazard ratio [HR], 6.51; 95% CI, 4.67-9.08) but was not associated with later mortality. Death after >3 years was predicted by age (HR, 1.86; 95% CI, 1.51-2.29 per decade), chronic heart failure (HR, 1.66; 95% CI, 1.02-2.70), and anemia (HR, 1.62; 95% CI, 1.09-2.41).The risk of mortality in patients with PE remained elevated compared with that in the general population throughout the follow-up period. The main driver of long-term mortality during the first 3 years was cancer. After that, mortality was predicted by age, chronic heart failure, and anemia.© 2023 The Author(s).