[Development and Validation of a Risk Prediction Model for Secondary Pulmonary Infarction in Elderly Patients With...

Area of Science:

• Cardiology
• Pulmonology
• Geriatrics

Background:

• Acute pulmonary embolism (PE) is a significant health concern in the elderly.
• Secondary pulmonary infarction (PI) is a serious complication of PE, particularly in older adults.
• Identifying risk factors and developing predictive tools for secondary PI is crucial for clinical management.

Purpose of the Study:

• To identify independent risk factors for secondary PI in elderly patients diagnosed with acute PE.
• To develop and validate a predictive model for secondary PI in this patient population.

Main Methods:

• A retrospective study included 147 elderly PE patients, divided into secondary PI (n=44) and non-secondary PI (n=103) groups.
• Stepwise regression analysis identified independent risk factors.
• A risk prediction model was constructed and validated on a separate cohort of 63 elderly PE patients.

Main Results:

• Independent risk factors for secondary PI included alcohol consumption, chronic bronchitis, emphysema, coronary heart disease, diabetes, and elevated D-dimer levels.
• The predictive model demonstrated high discriminatory power with an Area Under the Curve (AUC) of 0.936 in the modeling group and 0.917 in the validation group.
• The model showed high accuracy and clinical utility in both cohorts.

Conclusions:

• Elderly PE patients with specific comorbidities (alcohol use, chronic bronchitis, heart disease, emphysema, diabetes) and elevated D-dimer are at increased risk for secondary PI.
• The developed risk prediction model is accurate and effective for assessing secondary PI risk in elderly PE patients, aiding clinical decision-making.