AI Article Synopsis
- - The study examined the connection between renal dysfunction and short-term mortality in 1,330 hospitalized patients with acute pulmonary embolism (PE), finding that decreased kidney function at admission predicts higher mortality rates.
- - Patients were categorized based on their glomerular filtration rate (GFR), with those having GFR < 30 mL/min experiencing a significantly increased risk of dying within 30 days compared to those with better kidney function.
- - While renal dysfunction was linked to higher all-cause and PE-related mortality, rates of fatal bleeding were relatively low across all groups, suggesting that while impaired kidney function is critical for mortality risk, it doesn't significantly affect bleeding outcomes.
Article Abstract
Background: Acute pulmonary embolism (PE), due to hemodynamic disturbances, may lead to multi-organ damage, including acute renal dysfunction. The aim of our study was to investigate the predictive role of renal dysfunction at admission regarding the short-term mortality and bleeding risk in hospitalized PE patients.
Methods: The retrospective cohort study included 1330 consecutive patients with PE. The glomerular filtration rate (GFR) was calculated using the serum creatinine value and Cocroft-Gault formula, at hospital admission. Primary outcomes were all-cause mortality and PE-related mortality in the 30 days following admission, as well as major bleeding events.
Results: Based on the estimated GFR, patients were divided into three groups: the first with GFR < 30 mL/min, the second with GFR 30-60 mL/min, and the third group with GFR > 60 mL/min. A multivariable analysis showed that GFR at admission was strongly associated with all-cause death, as well as with death due to PE. Patients in the first and second group had a significantly higher risk of 30-day all-cause mortality (HR 7.109, 95% CI 4.243-11.911, p < 0.001; HR 2.554, 95% CI 1.598-4.081, p < 0.001). Fatal bleeding was recorded in 1.6%, 0.5% and 0.8% of patients in the first, second and in the third group (p < 0.05). There were no significant differences regarding major bleeding rates among the groups.
Conclusion: Renal dysfunction at admission in patients with acute pulmonary embolism is strongly associated with overall PE mortality.
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| http://dx.doi.org/10.1016/j.ijcard.2019.12.025 | DOI Listing |
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