Risk factors associated with provoked pulmonary embolism.
OBJECTIVE
This study aimed to investigate the risk factors associated with provoked pulmonary embolism (PE).


METHODS
This retrospective cohort study included 237 patients with PE. Patients that had transient risk factors at diagnosis were classified as having provoked PE, with the remaining patients being classified as having unprovoked PE. The baseline clinical characteristics and factors associated with coagulation were compared. We evaluated the risk factors associated with provoked PE.


RESULTS
Of the 237 PE patients, 73 (30.8%) had provoked PE. The rate of respiratory failure and infection, as well as the disseminated intravascular coagulation score and ratio of right ventricular diameter to left ventricular diameter were significantly higher in patients with provoked PE than in those with unprovoked PE. The protein and activity levels associated with coagulation, including protein C antigen, protein S antigen, protein S activity, anti-thrombin III antigen, and factor VIII, were significantly lower in patients with provoked PE than in those with unprovoked PE. Multivariate analysis showed that infection (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.4) and protein S activity (OR, 0.97; 95% CI, 0.95 to 0.99) were significantly associated with provoked PE.


CONCLUSIONS
Protein S activity and presence of infection were important factors associated with provoked PE. We should pay attention to the presence of infection in patients with provoked PE.
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Endri
E
Gjonbrataj
Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
Ji Na
JN
Kim
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.|Department of Internal Medicine, Mother Theresa University Hospital Centre, Tirana, Albania.
Juarda
J
Gjonbrataj
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Hye In
HI
Jung
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Hyun Jung
HJ
Kim
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Won-Il
WI
Choi
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D003141:Communicable Diseases / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017293:Protein S / Q000032:analysis*; D018455:Protein S Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D015415:Biomarkers; D017293:Protein S
Coagulation; Infection; Protein S; Provoked; Pulmonary embolism