Investigation of relationship between blood hemoglobin level and acute pulmonary embolism ın emergency setting

Investigation Of Relationship Between Blood Hemoglobin Level And Acute Pulmonary Embolism In Emergency SettingIntroduction: Pulmonary emboli occur when a proximal portion of a venous clot breaks off, travels through the veins, traverses the right ventricle, and lodges in the pulmonary arteries. Haematological variables influence endothelial function through the release of several factors Clinical studies have described an association among blood viscosity, haematocrit, haemoglobin and macro and microangiopathy. These studies have emphasized that low blood hemoglobin induced low blood viscosity, through the reduction of vessel wall stress, might inhibit the anti-thrombotic functions of endotelial cells and thats the reason of thrombosis.There is no clinical studies in literature which emphasize that low blood hemoglobin levels increase the risk of pulmonary embolism development. The goal of this study is to determine whether there is any relationship between serum hemoglobin value and pulmonary embolism.Material and Method: This one-on-one case-control study made in the Dokuz Eylul University Hospital Emergency Medicine between 01.01.2007 and 31.12.2009 which included 402 cases (201 patients, 201 control). Age, sex, hemoglobin, haematocrit, mean corpuscular volume, red cell distrubution width, platelet and Wells? scores of these cases at the age of 18 or above that exhibited pulmonary embolism are compared with the control group.Results: The mean age of 402 cases included in this study were 63.0 ± 16.6, 110 of them were women. The mean blood hemoglobine levels were 11.6±2.0 g/dl in group with pulmonary embolism and 13.0±1.7 g/dl in the control group (p<0.001). The mean blood red cell distrubution width levels were 16,0±3,0 in the group with pulmonary embolism and 14,0±3,0 in the control group. İn the group of pulmonary embolism which is included 201 cases, the 61 patient have middle-high risk wells score and the five patients have low risk well score. (p= 0,000)ConclusionThis study showed that serum low hemoglobin levels may be the independent risk factor in the formation of pulmonary embolism.