Key result
In patients with acute central pulmonary embolism, pulmonary infarction was independently associated with severe hypoxemic respiratory failure (OR 1.78; 95% CI 1.18-2.69; p=0.005).
Why the study?
Predisposing factors for pulmonary infarction are heterogeneous and clinically relevant outcomes in patients with acute PE complicated by pulmonary infarction remain poorly defined.
Does pulmonary infarction increase the risk of severe hypoxemic respiratory failure and mechanical ventilation in patients with central pulmonary embolism?
Cohort (n=645)
Does pulmonary infarction increase the risk of severe hypoxemic respiratory failure and mechanical ventilation in patients with central pulmonary embolism?
Odds Ratio: 1.78 (95% CI 1.18–2.69)
p-value: p=0.005
In patients with acute central pulmonary embolism, the presence of pulmonary infarction is associated with a significantly higher risk of severe hypoxemic respiratory failure and the need for mechanical ventilation.
PI risk factors identified retrospectively in central PE; leaves open impact on outcomes, needing prospective confirmation.
Background Given the heterogeneity of predisposing factors associated with pulmonary infarction (PI) and the lack of clinically relevant outcomes among patients with acute pulmonary embolism (PE) complicated by PI, further investigation is required.Methods Retrospective study of patients with central PE in an 11-year period. Data were stratified according to the diagnosis of PI. Multivariable logistic regression analysis was used to analyze factors associated with PI development and determine if PI was associated with severe hypoxemic respiratory failure and mechanical ventilation use.Results Of 645 patients with central PE, 24% (n = 156) had PI. After adjusting for demographics, comorbidities, and clinical features on admission, only age (OR 0.98, CI 0.96–0.99; p = 0.008) was independently associated with PI. Regarding outcomes, 35% (n = 55) had severe hypoxemic respiratory failure, and 19% (n = 29) required mechanical ventilation. After adjusting for demographics, PE severity, and right ventricular dysfunction, PI was independently associated with severe hypoxemic respiratory failure (OR 1.78; CI 1.18–2.69, p = 0.005) and mechanical ventilation (OR 1.92; CI 1.14–3.22, p = 0.013).Conclusions Aging is a protective factor against PI. In acute central PE, subjects with PI had higher odds of developing severe hypoxemic respiratory failure and requiring mechanical ventilation.
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Manzano et al. (2023) conducted a cohort in Central pulmonary embolism (n=645). Pulmonary infarction vs. No pulmonary infarction was evaluated on Severe hypoxemic respiratory failure (OR 1.78, 95% CI 1.18-2.69, p=0.005). In patients with acute central pulmonary embolism, pulmonary infarction was independently associated with severe hypoxemic respiratory failure (OR 1.78; 95% CI 1.18-2.69; p=0.005).
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