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KMID : 0191120120270111347
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Journal of Korean Medical Science
2012 Volume.27 No. 11 p.1347 ~ p.1353
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Comparison of Clinical and Imaging Characteristics and Outcomes between Provoked and Unprovoked Acute Pulmonary Embolism in Koreans
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Uhm Jae-Sun
Jung Hae-Ok
Kim Chan-Joon
Kim Tae-Hoon
Youn Ho-Joong
Baek Sang-Hong
Chung Wook-Sung
Seung Ki-Bae
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Abstract
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This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 ± 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 ± 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
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KEYWORD
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CT Obstruction Index, Provoked, Pulmonary Embolism, Unprovoked
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