RESUMEN
BACKGROUND: Pulmonary thromboembolism (PTE), often arising from deep vein thrombosis, remains a high-mortality condition despite diagnostic advancements. Prognostic models like Pulmonary Embolism Severity Index (PESI) and sPESI identify low-risk groups effectively. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, reflecting nutritional status and systemic inflammation, shows prognostic value in cancers and cardiovascular diseases. This study examines the relationship between in-hospital mortality HALP score and simplified PESI (sPESI) in PTE patients. METHODS: This retrospective observational study included patients diagnosed with PTE in the emergency department of a tertiary medical faculty from 2018 to 2023. PTE diagnosis was confirmed via computed tomography pulmonary angiography. Data on transthoracic echocardiography, D-dimer levels, demographics, laboratory results, PESI, sPESI, and HALP scores, and in-hospital mortality were collected. RESULTS: In this study, clinical characteristics of 171 patients with PTE were analysed. The average age was 61.88 ± 19.94 years, and 53.2% were female. Mortality was observed in 19.3% of patients. PESI and sPESI scores were significant predictors of mortality, with area under the curve values of 0.938 and 0.879, respectively. PESI score > 175.50 indicated a significantly higher mortality risk (HR = 18.208; P < .001), while sPESI >2.50 was also a strong predictor (HR = 11.840; P < .001). No significant cut-off value for HALP in predicting mortality was identified. CONCLUSIONS: Our study supports the reliability of sPESI and PESI scores in predicting in-hospital mortality in PTE patients. However, the prognostic value of the HALP score requires further investigation. Our findings highlight the need for developing risk stratification models. Key message What is already known on this topic? The PESI and sPESI scores are established prognostic models that effectively identify low-risk groups in patients with PTE. The HALP score, reflecting nutritional status and systemic inflammation, has shown prognostic value in cancer and cardiovascular diseases. What this study adds? This study demonstrates that while PESI and sPESI scores are significant predictors of in-hospital mortality in PTE patients, the HALP score does not have a significant cut-off value for predicting mortality. How this study might affect research, practice, or policy? The findings support the continued use of PESI and sPESI scores for risk stratification in clinical practice, potentially influencing guidelines and policies on managing PTE. Further research into the HALP score's role in other contexts may refine its prognostic utility.
RESUMEN
Background: Although SARS-CoV-2 infection often affects the lungs, pneumothorax is extremely rare. The aim of this study was to analyze the characteristics of patients who were hospitalized due to COVID-19 and who developed pneumothorax (PNX) and to analyze their risk factors. Methods: Patients who developed PNX, among the patients who were followed up in the hospital due to COVID-19 between 1 April 2020 and 1 April 2022, were included in the study. The mean and standard deviation values of the descriptive statistics were obtained from patient data. The entire application was carried out using IBM SPSS 26 (IBM Corp., Armonk, NY, USA). p values < 0.05 were considered statistically significant. Results: We observed that advanced age and male gender increase the risk of COVID-19 patientsdeveloping PNX, but smoking, sepsis, and being followed-up with mechanical ventilation do not increase this risk. In addition, we observed that the presence of an additional disease increases the mortality rate. Conclusion: We show that advanced age and male gender increase the risk for PNX, which is a rare complication of COVID-19, and that comorbidity is associated with mortality in these patients.