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. 2023 Nov 30;15(11):5961-5970.
doi: 10.21037/jtd-23-944. Epub 2023 Oct 23.

Characteristics of pulmonary infarction in patients with acute pulmonary embolism in China: a single-center retrospective observational study

Yuan Yuan  1 , Huan-Yong Wang  2 , Zhen-Chuan Xing  1 , Zi-Liang Hou  1 , Jin-Xiang Wang  1 , Shuai Zhang  1
Affiliations

Characteristics of pulmonary infarction in patients with acute pulmonary embolism in China: a single-center retrospective observational study

Yuan Yuan et al. J Thorac Dis. .

Abstract

Background: Pulmonary infarction (PI) is an uncommon complication of pulmonary embolism (PE). The risk factors of PI are still relatively unclear.

Methods: This was a single-center retrospective review conducted on 500 patients with PE. After applying the inclusion and exclusion criteria, 386 patients diagnosed with PE were enrolled in our study. These patients were then categorized into the PI group (n=64) and the non-PI group (n=322). A comparison was conducted between the two groups regarding the clinical characteristics.

Results: The occurrence of PI secondary to PE was 16.58%. In univariate analysis, recent trauma (21.9% vs. 9.9%, P=0.007), pleuritic chest pain (46.9% vs. 17.4%, P<0.001), hemoptysis (29.7% vs. 2.5%, P<0.001), fever (26.6% vs. 8.1%, P<0.001), lower limb edema/pain (37.5% vs. 14.0%, P<0.001), white blood cell (WBC) counts (37.5% vs. 24.5%, P=0.032), C-reactive protein (CRP) (65.6% vs. 41.3%, P<0.001), and pleural effusion (45.3% vs. 18.6%, P<0.001) were associated with an increased risk of PI. Multivariate analysis demonstrated that age [odds ratio (OR) 0.975, 95% confidence interval (CI): 0.951-0.999, P=0.045], pleuritic chest pain (OR 2.878, 95% CI: 1.424-5.814, P=0.003), hemoptysis (OR 10.592, 95% CI: 3.503-32.030, P<0.001), lower limb edema/pain (OR 2.778, 95% CI: 1.342-5.749, P=0.006) and pleural effusion (OR 3.127, 95% CI: 1.531-6.388, P=0.002) were independent factors of PI due to PE. No significant difference was recorded between the two groups in treatment and mortality.

Conclusions: Young patients were found to be a higher risk of PI. Pleural effusion was found to be a factor for PI. PI should be considered when pleuritic chest pain, hemoptysis, or lower limb edema/pain are present with peripheral opacity.

Keywords: Pulmonary embolism (PE); pulmonary infarction (PI); risk factor.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-944/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of patient selection. PE, pulmonary embolism; V/Q, ventilation-perfusion scintigraphy; CTPA, computed tomography pulmonary angiography.
Figure 2
Figure 2
Age distribution of pulmonary embolism and pulmonary infarction (A) and prevalence of pulmonary infarction as a function of age (B) in 386 patients with acute pulmonary embolism. PI, pulmonary infarction; PE, pulmonary embolism.
See this image and copyright information in PMC

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