title: Prognostic impact of pleural effusion in acute pulmonary embolism.
abstract: Background Pulmonary embolism (PE) is a common and life-threatening condition associated with considerable morbidity and mortality. Pleural effusion occurs in about one in three cases; however, data on its prognostic value are scarce. Purpose To investigate the association between pleural effusion and both 30-day and long-term mortality in patients with acute PE. Material and Methods We retrospectively evaluated 463 patients diagnosed with acute PE using computed tomography pulmonary angiography (CTPA). Echocardiographic, demographic, and laboratory data were collected. The study population was divided into two groups: patients with and without pleural effusions. Pleural effusion detected on CT was graded as small, moderate, and large according to the amount of effusion. The predictors of 30-day and long-term total mortality were analyzed. Results Pleural effusions were found in 120 patients (25.9%). After the 30-day follow-up, all-cause mortality was higher in acute PE patients with pleural effusions than in those without (23% versus 9%, P < 0.001). Also, patients with pleural effusions had significantly higher incidence of long-term total mortality than those without pleural effusions (55% versus 23%, P < 0.001). In a multivariate analysis, pleural effusion was an independent predictor of 30-day and long-term mortality (odds ratio [OR], 2.154; 95% confidence interval [CI], 1.186-3.913; P = 0.012 and OR, 1.591; 95% CI, 1.129-2.243; P = 0.008, respectively). Conclusion Pleural effusion can be independently associated with both 30-day and long-term mortality in patients with acute PE.
authors: 1 Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir Turkey.
authors: Tuncay
authors: T
authors: Kiris
authors: 2 Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training Research Hospital, Istanbul, Turkey.
authors: Selçuk
authors: S
authors: Yazıcı
authors: 3 Department of Radiology, Kayseri Education and Research Hospital, Kayseri, Turkey.
authors: Ali
authors: A
authors: Koc
authors: 4 Department of Radiology, Ordu State Hospital, Ordu, Turkey.
authors: Cinar
authors: C
authors: Köprülü
authors: 1 Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir Turkey.
authors: Zehra
authors: Z
authors: Ilke Akyildiz
authors: 1 Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir Turkey.
authors: Mustafa
authors: M
authors: Karaca
authors: 1 Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir Turkey.
authors: Cem
authors: C
authors: Nazli
authors: 1 Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir Turkey.
authors: Abdullah
authors: A
authors: Dogan
mesh_terms: D000208:Acute Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology*; D011379:Prognosis; D011655:Pulmonary Embolism / Q000150:complications* / Q000401:mortality*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Pulmonary embolism; mortality; pleural effusion