Glomerular filtration rate as a prognostic factor for long-term mortality after acute pulmonary embolism

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dc.contributor.authorĢibietis, Valdis
dc.contributor.authorKigitoviča, Dana
dc.contributor.authorVitola, Barbara
dc.contributor.authorStrautmane, Sintija
dc.contributor.authorSkride, Andris
dc.contributor.institutionDepartment of Internal Diseases
dc.contributor.institutionResidency Unit
dc.date.accessioned2021-07-14T14:40:01Z
dc.date.available2021-07-14T14:40:01Z
dc.date.issued2019-06-01
dc.descriptionPublisher Copyright: © 2019 The Author(s) Published by S. Karger AG, Basel.
dc.description.abstractBackground: In-hospital mortality for patients presenting with acute pulmonary embolism (PE) has been reported to be up to 7 times higher for patients with decreased estimated glomerular filtration rate (eGFR). However, few studies have assessed its effect on long-term mortality. Objective: To determine the impact of eGFR and creatinine clearance (CrCl) on long-term all-cause mortality following acute PE in association with other routine laboratory analyses and comorbidities. Patients/Methods: The prospective study enrolled 141 consecutive patients presenting with objectively confirmed acute PE. Demographic, clinical data, comorbidities, and laboratory values were recorded. CrCl and GFR were estimated using the Cockcroft-Gault, MDRD, and chronic kidney disease (CKD)-EPI equations. Patients were followed up at 90 days and 1 year after the event. Results: In univariate analyses, age, active cancer, PE severity index (PESI), CrCl and eGFR, D-dimer value, and high-density lipoprotein level were found to be significantly associated with mortality in 90 days and 1 year. Additionally, body mass index was significant in the 1-year follow-up. CrCl by Cockcroft-Gault (90-day: area under the curve [AUC] 0.763; 1-year: AUC 0.718) demonstrated higher discriminatory power for predicting mortality than eGFR by the MDRD (AUC 0.686; AUC 0.609) and CKD-EPI (AUC 0.697; AUC 0.630) equations. In multivariate analyses, active cancer, CrCl by Cockcroft-Gault (90-day: hazard ratio [HR] 0.948, 95% CI 0.919-0.979; 1-year: HR 0.967, 95% CI 0.943-0.991), eGFR by CKD-EPI (90-day: HR 0.948, 95% CI 0.915-0.983; 1-year: HR 0.971, 95% CI 0.945-0.998) were found to be independent predictors of mortality. eGFR by MDRD, D-dimer, and PESI value were significant prognostic factors for 90-day mortality. Conclusion: Decreased renal function is a prognostic factor for increased all-cause mortality 90 days and 1 year after acute PE.en
dc.description.statusPeer reviewed
dc.format.extent9
dc.format.extent247784
dc.identifier.citationĢibietis, V, Kigitoviča, D, Vitola, B, Strautmane, S & Skride, A 2019, 'Glomerular filtration rate as a prognostic factor for long-term mortality after acute pulmonary embolism', Medical Principles and Practice, vol. 28, no. 3, pp. 264-272. https://doi.org/10.1159/000497436
dc.identifier.doi10.1159/000497436
dc.identifier.issn1011-7571
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/5876
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85067408206&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofMedical Principles and Practice
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectGlomerular filtration rate
dc.subjectMortality
dc.subjectPulmonary embolism
dc.subjectRenal insufficiency
dc.subjectVenous thromboembolism
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleGlomerular filtration rate as a prognostic factor for long-term mortality after acute pulmonary embolismen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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