Effectiveness of the relationship between clinical, laboratory and imaging findings in patients with acute pulmonary emboly in determining early mortality and risk patient groups

Introduction-Purpose: APE means occlusion of the pulmonary artery or its branches by material originating elsewhere in the body (eg, thrombus, tumor, air, or fat). While APE is the 3rd most common cause of cardiovascular death, it is the 1st most common cause of patient death after surgery. The diagnostic process of APE begins with clinical suspicion. Evaluation of clinical probability and rapid diagnosis of APE are the first steps to ensure that diagnostic procedures and appropriate treatment are initiated. For this, methods such as Gestalt Score, Wells Score or revised Geneva Score are widely used in the standard approach for risk assessment in patients with suspected APE. In addition; Many parameters such as evaluation of clinical probability, patient symptom, symptom and history, presence of risk factors for VTE, systolic blood pressure, 12-channel ECG, chest X-ray and arterial blood gas analysis are also used. Laboratory tests are not diagnostic for APE, but can determine clinical suspicion and prognosis if APE is diagnosed. In this study, it was aimed to reveal the place of clinical, laboratory and imaging findings routinely used by physicians in the diagnostic approach in the daily practice of the emergency department in the diagnostic approach and to reveal the relationship between them, thus predicting the early mortality in APE cases and identifying risky patient groups. Materials and Methods: This retrospective study was conducted in the two-year period between January 2017 and January 2019 in accordance with the decision of the Sakarya University Clinical Research Ethics Committee dated 26.09.2019 and numbered 42 and the Declaration of Helsinki. It was carried out with the data of 109 patients who applied to the Ministry of Health Sakarya University Training and Research Hospital (SUEAH) Emergency Medicine Clinic. Conclusion: APE is undoubtedly a fatal condition in some patients, and diagnosis and treatment procedures should be started quickly in admissions to the emergency department. In particular, determining the patient group who died in the emergency service application can strengthen the physician's hand and move the patient follow-up and treatment to a different point. In our study; Vital parameters, a history of AF, and RDW, Lactate, pH, D-Dimer, among the parameters checked at admission, showed that APE patients could predict the dying group. We think that the cut-off values we determined can guide clinicians at the first application and also shed light on large-scale studies to be done.