Risk Factors for Short and Long-Term Mortality in Acute Pulmonary Thromboembolism: A Retrospective Study.

Purpose: Platelet-Lymphocyte Ratio (PLR) and Neutrophil-Lymphocyte Ratio (NLR) are the parameters investigated in acute pulmonary thromboembolism (aPTE) mortality. This study aimed to determine the prognostic value of NLR, PLR, and other parameters in aPTE. A retrospective cohort study was conducted in a Research and Training Hospital.

Patients and methods: The study included 346 aPTE cases, and mortality at the first week, first month, and sixth month were determined as endpoints. The medical files of the cases were examined. Age, sex, date of diagnosis, vital status, the last follow-up date, hemogram, lower extremity venous Doppler ultrasonography, and intensive care unit admissions were recorded. Cox regression analysis was performed to identify prognostic factors associated with mortality, and hazard ratio (HR) and a 95% confidence interval (CI) were reported.

Results: Median follow-up was 898.5 days. There was no significant difference in terms of sex on mortality. The deceased cases in the 1st month and 6th month were older than the survivors; among them, intensive care unit (ICU) admission rates were higher, and deep venous thrombosis (DVT) was less frequently detected. In the first week, ICU admission rates were higher in deceased cases, and DVT was determined less frequently among them. NLR was higher in all deceased patients, while PLR was elevated in deceased cases in the first and 6th months. ICU admission and DVT status were consistently associated with mortality across all three time points. NLR was identified as a good prognostic factor for the first month of mortality (95% CI: 1.017-1.168 HR: 1.090). PLR and age were poor prognostic factors; PLR was positively associated with 6th-month survival (95% CI: 1.001-1.005 HR: 1.003).

Conclusion: NLR is a good prognostic factor, and PLR and age are poor prognostic factors. DVT may help in early diagnosis, which may be associated with lower mortality.