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Renal dysfunction as intrahospital prognostic indicator in acute pulmonary embolism.
Int J Cardiol. 2019 Dec 13;:
Authors: Salinger-Martinovic S, Dimitrijevic Z, Stanojevic D, Momčilović S, Kostic T, Koracevic G, Subotic B, Dzudovic B, Stefanovic B, Matijasevic J, Miric M, Markovic-Nikolic N, Nikolic M, Miloradovic V, Kos L, Kovacevic-Preradovic T, Srdanovic I, Stanojevic J, Obradovic S
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.
PMID: 31866155 [PubMed - as supplied by publisher]