Study of the clinical profiles, risk factors and outcomes of patients with acute pulmonary embolism at Sa Kaeo Crown Prince Hospital
Keywords:
Acute pulmonary embolism, Deep vein thrombosis, S1Q3T3 patternAbstract
Context: Acute pulmonary embolism (PE) is an emergency condition with high mortality. While
the incidence of this condition is increasing worldwide, its incidence and clinical features have
yet to be studied extensively in Thailand.
Objectives: To evaluate the clinical profiles, risk factors and outcomes of patients with PE at
Sa Kaeo Crown Prince Hospital.
Materials and Methods: Eighty-nine patients from Sa Kaeo Crown Prince Hospital who were
diagnosed with PE for the first time between January 2011 and December 2020 were selected.
All PE patient data was recorded and analyzed – the data included demographics, risk factors,
symptoms, signs, investigations, treatments and outcomes.
Results: The incidence of PE has trended upward from 0-1 patients in 2011-2013, up to 21
patients in 2018, though the trend has slightly decreased in 2019 and 2020. The mean age
of patients was 57.7±15.7 years old. Females outnumbered males 1.9:1. Overall, 70.4% of
patients had at least one risk factor. The most common risk factor were malignancies (37.1%),
immobilization (17.9%), prior trauma (6.7%), prior surgery (6.7%) and congenital thrombophilia
(6.7%). The most common clinical presentations were desaturation (34.8%) and tachycardia
(34%). Chest radiographs were normal in half of the patients. Electrocardiographic findings
showed sinus tachycardia (62.3%) and an S1Q3T3 pattern (41%). Deep vein thrombosis and
massive PE were diagnosed in 29.2% and 12.4% of patients, respectively. The mortality rate of
patients was 30.3%, with the most common cause of death being malignancy.
Conclusions: The incidence of PE has trended upward from 2017-2020. The clinical features
were variable and nonspecific, although the majority of patients had at least one risk factor,
with malignancy being the most frequent risk factor and the most common cause of death.
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