Related Experiment Video
Updated: Jan 15, 2026
Establishment of a Minimally Invasive Rat Model of Pulmonary Embolism Using Autologous Blood Clots
Published on: October 25, 2024
Predictors of pulmonary infarction in pediatric pulmonary embolism: A retrospective cohort study
Shuxuan Li1, Min Wang2, Yongsheng Xu2
1Clinical School of Paediatrics, Tianjin Medical University, Tianjin, China.
Insights
Pulmonary infarction (PI) in children with pulmonary embolism (PE) is rare. Chest pain, elevated blood urea nitrogen (BUN), and high temperature are key risk factors for PI. A logistic regression model shows promise for predicting PI in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Cardiovascular Imaging
- Thrombosis Research
Background:
- Pulmonary infarction (PI) is an uncommon complication of pulmonary embolism (PE) in pediatric patients.
- Identifying risk factors and predictive indicators for PI in children is crucial for timely diagnosis and management.
- In situ pulmonary artery thrombosis is the predominant form of PE in this age group.
Purpose of the Study:
- To identify risk factors associated with the development of pulmonary infarction (PI) in pediatric patients with pulmonary embolism (PE).
- To evaluate the diagnostic utility of various predictive indicators and scoring systems for PI in children.
- To assess the efficacy of a logistic regression model in predicting PI.
Main Methods:
- Retrospective study of pediatric patients (<18 years) diagnosed with PE via computed tomography angiography (CTA).
- Data collection included demographics, medical history, clinical findings, laboratory results, and imaging.
- Analysis involved logistic regression and receiver operating characteristic (ROC) curves to identify risk factors and assess diagnostic performance of scoring systems (simplified Wells, revised Geneva, PE Severity Index).
Main Results:
- Among 41 pediatric PE patients, 15 had PI. Deep vein thrombosis was absent in 95% of cases.
- Simplified Wells, revised Geneva, and PE Severity Index scores showed poor predictive performance for pediatric PE or PI.
- Independent risk factors for PI included chest pain (aOR=6.85), blood urea nitrogen (BUN) (aOR=2.77), and maximum temperature (aOR=3.83).
- A logistic regression model achieved an AUC of 0.846 for PI prediction, significantly outperforming the simplified Wells score (AUC=0.640).
Conclusions:
- Chest pain, elevated BUN, and maximum temperature are significant independent risk factors for PI in pediatric PE.
- A logistic regression model demonstrates high efficacy in predicting PI, suggesting potential for developing a dedicated pediatric PI scoring system.
- The findings highlight the importance of clinical symptoms and basic laboratory values in identifying pediatric PE patients at risk for infarction.
Objective:
Pulmonary infarction (PI) complicating pulmonary embolism (PE) is rarely reported in pediatric populations. This study aimed to identify risk factors associated with PI development and evaluate the diagnostic utility of predictive indicators.
Methods:
This retrospective study enrolled patients aged <18 years diagnosed with PE by CTA. Data collected included demographics, medical histories, clinical manifestations, laboratory findings, and imaging results. Patients were assessed using simplified Wells score, simplified revised Geneva score, and Pulmonary Embolism Severity Index. Logistic regression and receiver operating characteristic curves were employed to evaluate risk factors and diagnostic efficacy.
Results:
Among 41 pediatric patients diagnosed with PE (26 non-PI vs. 15 PI), 95 % (39/41) showed no signs or history of deep vein thrombosis. The three scoring systems performed poorly in predicting pediatric PE or PI. Features nominally associated with PI (p < 0.05 but q > 0.05) included pleural effusion, maximum temperature, lymphocyte ratio, chest pain, blood urea nitrogen (BUN), neutrophil ratio, maximum D-dimer, leukocyte count, and neutrophil count. Chest pain (aOR = 6.85, p < 0.05), BUN (aOR = 2.77, p = 0.04), and maximum temperature (aOR = 3.83, p = 0.03) were identified as independent risk factors for the occurrence of PI. The logistic regression model for predicting PI (AUC = 0.846) significantly outperformed the simplified Wells model (AUC = 0.640).
Conclusions:
In situ pulmonary artery thrombosis represents the primary form of PE in pediatric patients. Chest pain, BUN, and maximum temperature were identified as independent risk factors for the occurrence of PI. The logistic regression model demonstrates excellent efficacy and may serve as a tool for the future development of a PI scoring system.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:29Pulmonary Embolism I: Introduction
01:27Pulmonary Embolism III: Nursing Management
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...