Impact of the Concurrent Acute Illness on the Short-Term Prognosis in Patients with Hemodynamically Stable Acute Pulmonary Embolism

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Objective: Acute pulmonary embolism (PE) is potentially fatal. Age, sex, chronic comorbidities, vital signs, and echocardiographic findings are well-known predictive indicators of the short-term mortality. However, the impact of concurrent acute illness on the prognosis is unclear.

Materials and Methods: This is a retrospective cohort study using data of hospitalized patients with a diagnosis of acute PE without hemodynamic instability. The outcome measure was 30-day all-cause mortality after diagnosis of acute PE.

Results: A total of 130 patients were analyzed (68.5±15.5 years old, 62.3% female). Eight patients (6.2%) had concurrent acute illness. The proportion of the simplified pulmonary embolism severity index (sPESI)≥1, and positive findings of right ventricular overload were similar between the two groups. Six patients (4.9%) without concurrent acute illness died; whereas, three patients (37.5%) with concurrent acute illness died (p=0.011). Concurrent acute illness was associated with 30-day all-cause mortality in the univariate logistic model (odds ratio: 11.6, 95% confidence interval; 2.2–60.4; p=0.008).

Conclusion: In patients with hemodynamically stable acute PE, short-term prognosis was significantly worse in patients with concurrent acute illness than those without concurrent acute illness.