The effect of presence of pleural effusion on prognosis in patients with pulmonary embolism

Aim: We aimed to find the frequency of pleural effusion in PE patients and to evaluate the prognosis of PE patients with pleural effusion by comparing the effect on hospital stay and mortality in PE patients with and without pleural effusion. Materials and methods: The study was planned retrospectively. Patients who applied to the Chest Diseases Polyclinic of Akdeniz University Medical Faculty Hospital between 01.01.2016 and 31.12.2021 or who were evaluated by the Chest Diseases Department by applying to the emergency service of Akdeniz University Medical Faculty Hospital were screened with the I26 ICD code and met the inclusion criteria. Results: The mean age of 482 patients in our study was 60.57±17.84 years, 234 (48.5%) women and 248 (51.5%) men. While 350 (72.6%) of the patients included in the study were diagnosed with CTPA, 132 (27.4%) patients were diagnosed with V/Q scintigraphy. Pleural effusion was observed in 179 (37.1%) of the patients. Pleural effusion was unilateral in 109 (60.9%) of the patients with pleural effusion. Considering the size of pleural effusion, 125 (69.8%) patients had minimal effusion, 50 (27.9%) patients had moderate pleural effusion, and 4 (2.2%) patients had massive pleural effusion. It was found that the number of days of hospitalization in patients with and without pleural effusion did not differ significantly, but the number of days in ICU was higher in patients with pleural effusion (p=0.13 p=0.01). In patients with pleural effusion, hospitalization and ICU admission were higher, and one-month and three-month survival rates were lower (p<0.05). However, when the discharge status was examined, it was found that there was a similar level of discharge and in-hospital death (p>0.05). It was seen that the probability of one month survival decreased 11.40 times in patients over 65 years of age, 8.89 times in patients with dilated right ventricle on CT, 3.44 times in patients who smoked, and 2.91 times in patients with HT. It was determined that 3-month survival probability was decreased 7.35 times in patients over 65 years of age, 13.78 times in patients with right ventricular dilation on CT, 13.31 times in patients with right ventricular dilation in TTE, and 2.97 times in patients who smoked. Conclusion: Our study found that hospital and intensive care hospitalizations were higher in PE patients with pleural effusion compared to those without effusion, and although there was no statistical difference between in-hospital mortality rates, 1- and 3-month mortality was higher in the group with pleural effusion. However, our study found that the presence of pleural effusion is not an independent risk factor for mortality in PE. However, we think that pleural effusion is quite common in PE patients and may be associated with mortality or may contribute negatively to mortality indirectly, although not directly, and may adversely affect the prognosis in PE. Key words: Pulmonary embolism, pleural effusion, prognosis, survival