KHẢO SÁT MỐI LIÊN QUAN GIỮA GÁNH NẶNG BỆNH ĐỒNG MẮC VÀ KẾT CỤC LÂM SÀNG Ở BỆNH NHÂN THUYÊN TẮC PHỔI TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Objective: To investigate the burden of comorbid conditions assessed by the Charlson Comorbidity Index (CCI) on adverse clinical outcomes in patients with pulmonary embolism including bleeding, hospital-acquired pneumonia, mortality during hospitalization. Subjects and Methods: We retrospectively analyzed inpatients with pulmonary embolism from January 2019 to September 2022. Result: We enrolled 177 patients. Multivariate analysis revealed that elevated troponin levels (P=0.019), Pulmonary Embolism Severity Index (PESI) score (P=0.000), initial anticoagulant type (P=0.036), and CCI (P=0.043) were correlated with poor clinical outcomes. Using ROC curve and Youden J index, we identified an appropriate cutoff threshold for CCI at 1 point, with a sensitivity of 91.1% and specificity of 35.5%. The area under the curve was 0.655 (P<0.001). There were 84 patients (47.5%) in the CCI ≤ 1 group and 93 patients (52.5%) in the CCI > 1 group. The rate of adverse outcomes in the CCI ≤ 1 group was 20.2%, while in the CCI > 1 group, it was 41.9% (P=0.002). Conclusion: The study demonstrated that a CCI threshold > 1 is associated with an increased risk of adverse outcomes, including hospital-acquired pneumonia, bleeding, and mortality in hospital.