What are the mortality markers in elderly patients with acute pulmonary embolism?

Objective: This study investigates characteristics and predictors of mortality among elderly patients with acute pulmonary embolism (APE).

Patients And Methods: Data on patients with the diagnosis of APE at the first admission to two centers between January 2012 and March 2022 were screened retrospectively. Patients aged 65 years and older were categorized as the elderly group while patients between 18 and 64 years of age constituted the non-elderly group.

Results: Among the 361 enrolled patients, the average age in the non-elderly group was 51.0 (18.0-64.0) years and the average age in the elderly group was 76 (65.0-92) years. While male patients were the majority in the non-elderly group, there was a higher proportion of female patients in the elderly group (p=0.001). In multivariate regression analysis, the independent risk factors of mortality among elderly patients were oxygen saturation [odds ratio (OR): 1.163, 95% confidence interval (CI): 1.613-9.476; p=0.044], C-reactive protein (CRP) (OR: 1.133, 95% CI: 1.041-1.234; p=0.004), simplified Pulmonary Embolism Severity Index (sPESI) score (OR: 3.910, 95% CI: 1.613-9.476; p=0.003), absence of deep vein thrombosis (OR: 12.88, 95% CI: 1.321-125.739; p=0.028), and leukocyte count (OR: 2.591, 95% CI: 1.015-6.617; p=0.047). In ROC analysis, the cut-off values for mortality prediction were ≥7.7 mg/dL for CRP, >0.125 ng/mL for troponin, and ≥2 for the sPESI score.

Conclusions: If CRP of ≥7.7, troponin of >0.125, and sPESI score of ≥2 are present in elderly patients with APE, extra attention should be paid to the risk of mortality and the utmost care should be taken in planning the monitoring of these patients.