Early Risk Stratification in Acute Pulmonary Embolism using Inflammatory and Hematologic Biomarkers

Area of Science:

• Cardiology
• Hematology
• Pulmonology

Background:

• Accurate risk stratification for acute pulmonary embolism (PE) is challenging, especially for intermediate-risk patients.
• Hematologic and inflammatory markers may offer additional prognostic insights.
• Early identification of high-risk PE patients is crucial for timely intervention.

Purpose of the Study:

• To assess the predictive value of readily available hematologic and inflammatory markers for in-hospital adverse events in acute PE patients.
• To identify independent predictors of adverse outcomes in acute PE.
• To evaluate the combined discriminative performance of these markers for risk stratification.

Main Methods:

• Retrospective analysis of 88 acute PE patients (2023-2024).
• Evaluation of red blood cell distribution width (RDW), white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP).
• Logistic regression and ROC curve analysis to identify predictors and assess discrimination.

Main Results:

• Adverse events (hemodynamic instability, cardiac arrest, death) occurred in 14.8% of patients.
• Patients with adverse events showed significantly higher RDW, WBC, NLR, PLR, and CRP levels.
• RDW, WBC, and NLR were identified as independent predictors of in-hospital adverse events (p<0.05).

Conclusions:

• Red blood cell distribution width, white blood cell count, and neutrophil-to-lymphocyte ratio are independent predictors of in-hospital adverse events in acute PE.
• The combination of these markers demonstrated enhanced discriminative performance (AUC 0.880).
• These hematologic markers can improve early risk stratification in acute pulmonary embolism management.