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Srce i krvni sudovi
2017, vol. 36, br. 4, str. 233-237
jezik rada: engleski
vrsta rada: originalan članak
objavljeno: 06/07/2018
doi: 10.5937/siks1704233S
Simptomatska arterijska bolest kao prediktor hospitalne i šestomesečne prognoze kod obolelih od akutne plućne tromboembolije
aKlinički centar Niš, Klinika za kardiovaskularne bolesti + Univerzitet u Nišu, Medicinski fakultet
bKlinički centar Niš, Klinika za kardiovaskularne bolesti
cVojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd
dVojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd

e-adresa: draganastanojevic1@gmail.com

Sažetak

Uvod: Povezanost postojećeg arterijskog oboljenja i ishoda kod obolelih od plućne tromboembolije (PTE) nije dovoljno istražen. Cilj rada je utvrđivanje udruženosti pozitivne anamneze o simptomatskoj arterijskoj bolesti i intrahospitalne i šestomesečne prognoze kod bolesnika sa akutnom PTE. Metode: Od 237 bolesnika primljenih u intenzivnim negama tokom 6 godina, 40 bolesnika je imalo pozitivnu anamnezu za arterijsko oboljenje (24 je imalo koronarnu bolest- infarkt miokarda ili revaskularizaciju miokarda, 15 je imalo šlog i 1 je imao perifernu arterijsku bolest). Intrahospitalna i šestomesečna prognoza su poređene kod bolesnika sa i bez simptomatske arterijske bolesti. Incidenca šestomesečnog major krvarenja je takođe poređena među grupama. Rezultati: Intrahospitalni i šestomesečni mortalitet je bio značajno veči kod bolesnika sa pozitivnom anamnezom za perifernu arterijsku bolest (30.0% vs. 9.1%, p=0.001 i 35.0% vs. 13.7%, p=0.02). Verovatnoća za intrahospitalni i šestomesečni mortalitet ujednačen za godine starosti i pol je bila značajno viša kod bolesnika sa pozitivnom anamnezom o arterijskom oboljenju (HR=3.668 95%CI 1.766-7.618, p<0.001, i HR=2.948, 95%CI 1.545-5.626, p=0.001). Pozitivna anamneza o arterijskoj bolesti je takođe bila udružena sa povišenim rizikkom od major krvarenja (22.5% vs. 11.5%, p=0.078) tokom 6 meseci praćenja (HR=2.230 95%CI 1.031-4.823, p=0.042). Zaključak: Pozitivna anamneza o postojanju simptomatskog arterijskog oboljenja je udružena sa povišenim rizikom od intrahospitalnog i šetomesečnog mortaliteta, kao i sa rizikom od major krvarenja kod bolesnika sa PTE.

Ključne reči

plućna tromboembolija; simptomatska arterijska bolest; prognoza; krvarenje

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