Long-Term Outcome and Prognostic Factors of Mortality in Patients With Surgical Pulmonary Embolectomy

Objectives Acute pulmonary embolism (PE) is a significant cardiovascular risk and one of the causes of disability and death among hospitalised patients. Surgical pulmonary embolectomy should be considered for patients with high-risk PE when thrombolysis is contraindicated or has failed. The objective of the present study was to evaluate the long-term outcome and identify the factors that are associated with the prognosis of surgical embolectomy for acute PE in response to this knowledge gap. Material and Methods A retrospective cohort analysis of 59 patients with acute PE who underwent pulmonary embolectomy was conducted using survival analysis. In the present study, the average follow-up duration was 1083.2 ± 1341.1 days, and the mortality rate was 15.3%. The Cox proportional hazard regression model was used to explore prognostic factors. Therefore, Kaplan-Meier survival curves were created, and log-rank tests were used to assess prognostic factors. Results For the total cohort, 7-day, 14-day, 30-day, and 90-day survival probabilities were 91.5% (95% confidence interval (CI) 84.7-98.9), 89.7% (95% CI 82.3-97.9), 86.1% (95% CI 77.5-95.5), and 86.1% (95% CI 77.5-95.5), respectively. Using multivariable analysis of Cox hazard regression, preoperative mechanical circulatory support (Hazard ratio (HR) 6.03, 95% CI 1.05-34.63) and postoperative major adverse cardiac events (HR 26.98, 95%CI 5.36-135.91) were associated with mortality. Conclusion The preoperative mechanical circulatory support and postoperative major adverse cardiac events were independent prognostic factors for PE patients who underwent pulmonary embolectomy. The predictive performances of these prognostic factors should be validated in the future.