Prognostic significance of thrombocytopenia in acute pulmonary embolism

A reduced platelet count has been reported in acute pulmonary embolism. This study investigated the prognostic role of thrombocytopenia in acute pulmonary embolism (APE). This study retrospectively reviewed 225 consecutive APE patients. Diagnosis of APE was confirmed by either spiral computed tomography or high probability ventilation and perfusion lung scans. On the day of admission, all enrolled patients underwent initial blood tests, including platelet count. Patient exclusion criteria included intermediate- or low-probability lung scan, clinical suspicion of septic emboli, recurrent APE, chronic lung disease, hematological malignancy, liver cirrhosis, gastrointestinal bleeding or stroke within the preceding 6 months and recent surgery with bleeding risk. Assessment of the prognostic value of initial thrombocytopenia was based on either 30-day death or 30-day composite event (death, cardiopulmonary resuscitation, mechanical ventilation, thrombolytic treatment and vasopressor therapy). The 30-day mortality rate was 21.8%, and the 30-day composite event rate was 34.2% in this study. Incidence of thrombocytopenia significantly differed between the 30-day death group and the 30-day survival group (P < 0.001) and between the 30-day composite endpoint group and the 30-day composite event-free survival group (P < 0.001). Multivariate Cox regression analysis revealed the hazard ratio for thrombocytopenia was 1.63 (95% CI= 0.92-2.90) for 30-day death and 1.76 (95% CI = 1.07-2.89) for 30-day composite event. The study revealed thrombocytopenia is a predictor of short-term composite event. The simple blood examination is a rapid, noninvasive and effective test for short-term risk stratification of APE.