The demographics and clinical characteristics of patients.
There were 256 patients in all. 51 patients who without complete clinical information were excluded. 205 patients were enrolled in this study, among whom 95 patients were low risk, 56 patients were intermediate-low risk, 30 patients were intermediate-high risk, 24 patients were high risk. The median age was 68 (interquartile range, (IQR):23-92) years old. The number of male and female patients were 87(42.4%) and 118 (57.6%) respectively. pleural effusion, pulmonary infection, coronary heart disease, hypertension, deep venous thrombosis, cardiac arrhythmia, carcinoma, respiratory failure, renal dysfunction, diabetes, chronic obstructive pulmonary disease (COPD) were reported in 38 (18.5%), 108(52.7%), 57(27.8%), 79(38.5%), 33(16.1%), 27(13.2%), 24(11.7%),27(13.2%),13(6.3%), 16 (7.8%), 14 (6.8%) patients respectively (Table 1).
Table 1
The Demographics and clinical characteristics of 205 patients.
| Total (n=205) | Low-risk (n=95) | Intermediate-low risk (n=56) | Intermediate-high risk (n=30) | High risk (n=24) | P value |
Gender(male%) | 87 (42.4%) | 43(45.3%) | 26 (46.4%) | 10 (33.3%) | 8 (33.3%) | 0.474 |
Age (years) | 68(23-92) | 64(23-91) | 71(40-90) | 67.5(37-92) | 70.5(47-88) | 0.001 |
DD | 1.32(0.02-20.54) | 0.87(0.02-8.38) | 1.80(0.03-20.54) | 2.62(0.55-11.62) | 2.83(0.1-10.64) | 0.000 |
TNF-α | 10.9(4-322) | 12.3(4-322) | 9.83(4-115) | 10.5(5.2-38.5) | 9.33(4-57.8) | 0.174 |
IL-2R | 487(122-2779) | 458(181-2779) | 517(122-1946) | 503(266-963) | 518.5(154-1346) | 0.046 |
IL-6 | 8.59(2-212) | 8.2(2-208) | 7.9(2-212) | 8.86(2-53.5) | 9.70(2.26-49.9) | 0.962 |
IL-8 | 18.8(5-1213) | 22.8(6.8-1213) | 18.8(5-980) | 16(5-180) | 14.9(5.65-132) | 0.046 |
CRP | 8(1-200) | 8(1-160) | 8(1-200) | 11(1-168) | 7(1-160) | 0.357 |
WBC | 6.8(1.8-17.7) | 6.4(3.1-17.7) | 6.41(1.8-14.2) | 5.9(3.8-11.1) | 6.11(1.8-13.5) | 0.987 |
ESR | 27(2-120) | 28(2-120) | 31.5(2-120) | 26(2-97) | 24(2-87) | 0.530 |
Pleural effusion | 38(18.5) | 27(28.4) | 6(10.7) | 4(13.3) | 1(4.2) | 0.007 |
Pulmonary infection | 108(52.7) | 53(55.8) | 33(58.9) | 11(36.7) | 11(45.8) | 0.188 |
Coronary heart disease | 57(27.8) | 11(11.6) | 17(30.4) | 19(63.3) | 10(41.7) | 0.000 |
Hypertension | 79(38.5) | 32(33.7) | 24(42.9) | 13(43.3) | 10(41.7) | 0.620 |
DVT | 33(16.1) | 11(11.6) | 9(16.1) | 5(16.7) | 8(33.3) | 0.081 |
Cardiac arrhythmia | 27(13.2) | 10(10.5) | 9(16.1) | 6(20) | 2(8.3) | 0.439 |
Carcinoma | 24(11.7) | 12(12. 6) | 10(17.9) | 1(3.3) | 1(4.2) | 0.140 |
Respiratory failure | 27(13.2) | 5(5.3) | 8(14.3) | 9(30) | 5(20.8) | 0.003 |
Renal dysfunction | 13(6.3) | 4(4.2) | 4(7.1) | 2(6.7) | 3(12.5) | 0.508 |
Diabetes | 16(7.8) | 4(4.2) | 8(14.3) | 1(3.3) | 3(12.5) | 0.088 |
COPD | 14(6.8) | 7(7.4) | 4(7.1) | 2(6.7) | 1(4.2) | 0.956 |
Note: D-dimer (DD); c-reaction protein (CRP); white blood cell (WBC); erythrocyte sedimentation rate (ESR); deep venous thrombosis (DVT); chronic obstructive pulmonary disease (COPD) |
The comparison of clinical characteristics among different PE severity groups.
Medians of age (P=0.001), D-dimer (P=0.000), IL-2R (P=0.046) and IL-8 (P=0.046) were found statistically different among different PE severity groups. A raising tendency of D-dimer levels and a decreasing tendency of IL-8 levels were detected as PE severities increase. No significant differences were found in other biomarkers such as TNF-α, IL-6, CRP, WBC, and ESR among groups. With respect to commodities, rates of pleural effusion (P=0.007), coronary heart disease (P=0.000) and respiratory failure (P=0.003) were found statistically different among groups (Table 1).
Correlation between biomarkers and PE severity.
A spearman rank correlation analysis showed a negative correlation between IL-8 levels and PE severity (r= -0.466, P=0.018). A week negative correlation between TNF-α and PE severity was also found (r=-0.14, P=0.046). There was a positive correlation between Age and PE severities (r=0.280, P=0.000) and between D-dimer and PE severities (r=0.527, P=0.000) respectively. No significant correlation was found between other biomarkers (IL-2R, IL-6, CRP, WBC, ESR) and PE severity (Table 2).
Table 2
Correlation between PE severity and cytokine levels. (Spearman rank correlation analysis).
PE severity | Variables | Correlation coefficient | P value |
| Age | 0.280 | 0.000 |
| DD | 0.527 | 0.000 |
| TNF-α | -0.14 | .046 |
| IL-2R | 0.072 | 0.308 |
| IL-6 | 0.11 | 0.118 |
| IL-8 | -0.466 | 0.018 |
| CRP | 0.019 | 0.784 |
| WBC | -0.042 | 0.547 |
| ESR | 0.064 | 0.36 |
Note: D-dimer (DD); c-reaction protein (CRP); white blood cell (WBC); erythrocyte sedimentation rate (ESR); |
Association between commodities and PE severity.
An ordinal multinomial Logistic regression revealed that with comorbidities of pleural effusion [0.433 (0.196-0.957) (P=0.039)], coronary heart disease [3.76 (1.99-7.10) (P=0.000)], deep venous thrombosis [2.40 (1.15-5.01) (P=0.019)] respiratory failure [2.92 (1.33-6.4) (P=0.007)] were correlated with the severity of PE. While no significant correlation was found between PE severity and commodities regarding pulmonary infection, hypertension, cardiac arrhythmia, carcinoma, renal dysfunction, diabetes, and COPD in current study (Table 3).
Table 3
The correlation between comorbidities and PE severity. (Ordinal multinomial Logistic regression analysis)
Comorbidities(without=1) | Odds ratio | 95%CI | P value |
Pleural effusion | 0.433 | 0.196-0.957 | 0.039 |
Coronary heart disease | 3.761 | 1.992-7.102 | 0.000 |
DVT | 2.404 | 1.152-5.014 | 0.019 |
Respiratory failure | 2.921 | 1.333-6.402 | 0.007 |
Pulmonary infection | 1.152 | 0.631-2.101 | 0.645 |
Hypertension | 0.957 | 0.538-1.703 | 0.881 |
Cardiac arrhythmia | 1.279 | 0.579-2.823 | 0.543 |
Carcinoma | 1.084 | 0.441-2.665 | 0.860 |
Renal dysfunction | 1.233 | 0.414-3.676 | 0.707 |
Diabetes | 1.923 | 0.704-5.25 | 0.202 |
COPD | 0.872 | 0.290-2.624 | 0.808 |
Note: deep venous thrombosis (DVT); chronic obstructive pulmonary disease (COPD) |