Clinical Profile and Risk Factors Associated with Hospital-Acquired Pulmonary Embolism

Hospital-acquired pulmonary embolism (HA-PE) is the first occurrence of PE during hospitalization. This study aimed to analyze the clinical characteristics, incidence and mortality rates, and death-associated risk factors in patients with HA-PE.

A retrospective analysis was conducted on the demographic data, laboratory test results, and examination findings of 196 patients with HA-PE admitted to Yichang Central People's Hospital from June 1, 2018, to May 31, 2023.

Among the 196 patients with HA-PE, 98 (50%) were men and 98 (50%) were women, with a mean age of 65.29 (±12.31) years. Higher risk severity in HA-PE was correlated with elevated in-hospital all-cause (χ² = 50.581, P < 0.001) and HA-PE-specific mortality rates (χ² = 44.755, P < 0.001). Critical parameters including heart rate (H = 37.744, P < 0.001), respiratory rate (H = 13.885, P < 0.001), arterial oxygen saturation (SaO₂) (H = 48.309, P < 0.001), systolic blood pressure (H = 33.356, P < 0.001), and diastolic blood pressure (H = 27.065, P < 0.001) were significantly associated with HA-PE risk level. Syncope was more prevalent in high-risk patients than in lower-risk groups (χ² = 53.859, P < 0.001). Multivariate ordinal logistic regression identified increased post-HA-PE heart rate, reduced SaO₂, lowered systolic blood pressure, syncope, and recent blood transfusion as independent predictors of HA-PE severity. Kaplan-Meier analysis revealed that high-risk patients had significantly reduced 5-year cumulative survival compared to medium- and low-risk groups. Syncope (odds ratio [OR] = 0.152, 95% confidence interval [CI] = 0.031-0.740, P = 0.02) emerged as an independent risk factor for in-hospital mortality in nonsurgically and surgically treated patients (OR = 0.032, 95% CI = 0.003-0.320, P = 0.003).

The heart rate, SaO₂, blood pressure, syncope, and recent blood transfusion history significantly influence HA-PE risk stratification. Syncope is a critical prognostic indicator in patients with HA-PE. Future prospective studies are warranted to further delineate HA-PE risk factors.