Abstract:

Objective To analyze the factors affecting patients with active tuberculosis (ATB) combined with acute pulmonary thromboembolism (APTE), in order to intervene the progression of the patients' disease early and improve the prognosis. Methods A total of 121 patients with ATB were studied. Forty-one cases with APTE diagnosed by CT pulmonary arteriography (CTPA) were in the ATB+APTE group, and 80 patients with ATB were in the ATB group. The general data of the two groups were collected and analyzed, including the differences in TB lesion sites and drug resistance, clinical manifestations and first laboratory indexes after admission. The influencing factors of ATB patients with concurrent APTE were analyzed by multifactorial Logistic regression, and continuous indexes with significant differences were selected, and the subjects' work characteristics (ROC) curves were plotted to assess the predictive value. Results Compared with the ATB group, patients in the ATB+APTE group were older, and Padua scores were higher, red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), D-dimer were higher, the proportion of cough and expectoration increased and levels of partial pressure of carbon dioxide, hemoglobin (Hb), and albumin were lower (P<0.05). Multifactorial Logistic regression analysis showed that higher Padua score, RDW and D-dimer were risk factors for patients with ATB combined with APTE, and the predicted area under the curve (AUC) for ATB combined with APTE were 0.657 (95%CI: 0.549-0.764) and 0.889 (95%CI: 0.827-0.951) for RDW and D-dimer, respectively. Conclusion In patients with ATB, the risk of combined APTE is increased with increased frequency of sputum and elevated Padua score, RDW and D-dimer, alerting to the development of APTE events.

Key words: tuberculosis, pulmonary, pulmonary embolism, root cause analysis