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Related Concept Videos

Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Pulmonary Embolism I: Introduction01:19

Pulmonary Embolism I: Introduction

A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...

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A prognostic prediction model for acute pulmonary embolism.

Yang Zhan1, Xing Che2

  • 1Department of Intensive Care Unit, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou City, Jiangsu Province, China.

Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
|September 12, 2024
PubMed
Summary

This study identified key prognostic factors for acute pulmonary embolism (APE), including age, right ventricular dysfunction, white blood cell count, albumin/fibrinogen ratio, Prognostic Nutritional Index, and Systemic Inflammation Response Index. A predictive model using these factors shows good accuracy for 30-day mortality risk.

Keywords:
Acute pulmonary embolismprediction modelprognosisrisk factor

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Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Medical Prognostics

Background:

  • Acute pulmonary embolism (APE) is a critical medical emergency with high mortality.
  • Identifying prognostic factors is crucial for managing APE patients in intensive care units.

Purpose of the Study:

  • To explore independent prognostic factors for APE.
  • To develop and validate a predictive model for 30-day mortality in APE patients.

Main Methods:

  • Retrospective analysis of 252 APE patients.
  • Cox multivariate regression for risk factor identification.
  • Nomogram model construction and evaluation using R software.

Main Results:

  • The 30-day mortality rate was 16.6%.
  • Independent risk factors identified: age ≥ 62.5, right ventricular dysfunction (RVD), white blood cell count (WBC) ≥ 13.1, albumin/fibrinogen ratio (AFR) < 9.15, Prognostic Nutritional Index (PNI) < 50.3, and Systemic Inflammation Response Index (SIRI) ≥ 1.05.
  • The nomogram model achieved an AUC of 0.908 for predicting 30-day mortality.

Conclusions:

  • Age, RVD, WBC, AFR, PNI, and SIRI are significant independent risk factors for APE mortality.
  • The developed nomogram model provides a valuable tool for predicting prognosis in APE patients.