ABSTRACT
OBJECTIVE: To analyze the clinical features of patients with pulmonary thromboembolism complicated with pleural effusion and to explore the factors affecting pleural effusion caused by pulmonary thromboembolism and the prognostic factors of patients with pulmonary thromboembolism.METHODS: Clinical data of 150 patients with confirmed pulmonary thromboembolism were all obtained from the national multi-center registration and research database of pulmonary thromboembolism in our hospital from January 2012 to December 2018.Patients with pulmonary thromboembolism were divided into two groups:group of pulmonary thromboembolism combined with pleural effusion and group without pleural effusion.The differences between the two groups in demographic characteristics,basic diseases,clinical manifestations and laboratory examination results were retrospectively compared.RESULTS: In the 150 patients with pulmonary thromboembolism,there were 48 patients with pleural effusion,accounting for 32%.Compared with the without pleural effusion,the pulmonary thromboembolism with pleural effusion was more common after surgery or traumatic history(22% vs.8%),chest pain(54% vs.22%),dyspnea(65% vs.39%)and fever(8% vs.1%)had a higher incidence,white blood cell count(10.75 × 109/L vs.8.56×109/L),C-reactive protein(67.45 mg/dL vs.17.21 mg/dL)and prothrombin time(13.75 s vs.12.20 s)increased significantly,the difference being significant(P<0.05).Multivariate Logistic regression analysis showed that C-reactive protein,chest pain and dyspnea were independent influencing factors of pleural effusion in patients with pulmonary thromboembolism(OR values were 1.011,2.922,2.308,P<0.05).Kaplan-Meier survival analysis showed that the patients with pleural effusion had poor prognosis.Multivariate Cox risk regression analysis showed that pleural effusion was an independent risk factor for poor prognosis in patients with pulmonary thromboembolism.CONCLUSION: The patients with pulmonary thromboembolism have high incidence of pleural effusion,especially after surgery or trauma;in patients with unexplained pleural effusion,if there is chest pain and dyspnea,and elevated C-reactive protein,pulmonary thromboembolism should be highly suspected of.If necessary,computed tomography pulmonary angiography should be performed to confirm the diagnosis.Pleural effusion is an independent risk factor for poor prognosis in patients with PTE.