title: Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU.
abstract: Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission.Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients.Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%;p< 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%;p= 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n= 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50-1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96-463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01-0.98) were found as independent predictors of mortality.Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients.
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Begüm
authors.identifier: 0000-0003-2920-9214
authors.initials: B
authors.lastname: Ergan
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Research Hospital, Medical Intensive Care Unit, Ankara, Turkey.
authors.forename: Recai
authors.initials: R
authors.lastname: Ergün
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Çalışkan
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Kutlay
authors.initials: K
authors.lastname: Aydın
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Murat Emre
authors.initials: ME
authors.lastname: Tokur
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Yusuf
authors.identifier: 0000-0002-0130-4730
authors.initials: Y
authors.lastname: Savran
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Uğur
authors.identifier: 0000-0002-2949-4265
authors.initials: U
authors.lastname: Koca
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Bilgin
authors.initials: B
authors.lastname: Cömert
authors.affiliation: School of Medicine, Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Necati
authors.identifier: 0000-0003-1835-4133
authors.initials: N
authors.lastname: Gökmen
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D014421:Turkey / Q000453:epidemiology