Clin Appl Thromb Hemost. 2026 Jan-Dec;32:10760296261479848. doi: 10.1177/10760296261479848. Epub 2026 Aug 17.
ABSTRACT
BackgroundThe relationship between onset timing of hospital-associated pulmonary embolism (HAPE) and mortality remains unclear. This study assessed the independent prognostic role of onset timing for 6-month all-cause mortality among HAPE patients, with adjustment for the pulmonary embolism severity index (PESI) and treatment regimens.MethodsIn this retrospective cohort study, 140 HAPE patients were enrolled. According to onset time, patients were stratified into two groups: in-hospital onset (n = 94) and post-discharge onset (n = 46). Survival curves were plotted via the Kaplan-Meier (KM) methods, and intergroup differences were assessed using the log-rank test. Univariate and multivariate Cox regression were performed.ResultsOverall, 6-month mortality was 27.1% (38/140). Patients with post-discharge onset demonstrated a substantially higher mortality rate than those with in-hospital onset (39.1% vs. 21.3%, P = 0.026; log-rank P = 0.03). In the univariate Cox model, age, post-discharge onset of HAPE, admitting departments, general anesthesia, pulse rate (PR) ≥ 110 beats per minute (bpm), systolic blood pressure (SBP) < 100 mmHg, oxygen saturation (SpO) < 90%, altered mental status, intermediate- or high-risk PE risk stratification and higher PESI score were identified as potential predictors of 6-month mortality (all P < 0.1). Multivariate Cox regression revealed post-discharge onset as an independent correlate of 6-month mortality (HR = 1.95, 95% CI: 1.01-3.76, P = 0.046). Subgroup analyses confirmed the robustness of findings.ConclusionPost-discharge onset was identified as an independent risk factor for 6-month all-cause mortality in patients with HAPE. Venous thromboembolism (VTE) assessment before discharge should be emphasized.
PMID:42606364 | DOI:10.1177/10760296261479848