Evaluation of the effects of kidney function tests on prognosis and mortality in geriatric patients with a pulmonary embolism

Hatice Şeyma Akça 1 * , Serdar Özdemir 2, Abuzer Özkan 2, Serkan Küçüktürk 3, Fulya Köse 1
More Detail
1 Department of Emergency Medicine, Karaman Education and Research Hospital, University of Karamanoğlu Mehmet Bey, Karaman, Turkey
2 Department of Emergency Medicine, Ümraniye Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
3 Department of medical biology, Karaman Education and Research Hospital, University of Karamanoğlu Mehmet Bey, Karaman, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 19, Issue 5, pp. 23-27. https://doi.org/10.23950/jcmk/12503
OPEN ACCESS 1028 Views 750 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: The instant study’s aim is to investigate the effect that BUN and creatinine values have on a prognosis in geriatric patients that are diagnosed with pulmonary embolism. Material and methods: Our study was planned as a retrospective data review and included patients over the age of 65 with a diagnosis of pulmonary embolism who were admitted applied to Ümraniye Training and Research Hospital between March 1, 2020, and March 1, 2022. Statistical analysis was performed using SPSS version 26.0.
Results: The study included 148 patients, and 66.89% of them were women. The mortality rate was 28.38%. Considering the blood gas parameters, there was a statistically significant relationship between PH and low saturation and mortality (p=0.029, p=0.001, respectively). Although creatinine values were higher in non-surviving patients than in surviving patients, it was not statistically significant (p=0.252). Blood urea nitrogen was statistically significantly higher in patients who died (p=0.001). Sodium and potassium values were also not associated with mortality (p=0.991, p=0.886, respectively).
Conclusion: The effect of kidney function tests on the prognosis is very important in managing pulmonary embolism. BUN will be more beneficial to the clinician than creatinine and plasma electrolytes in the management of patients with pulmonary embolism.
Keywords: pulmonary embolism, BUN, creatinine, sodium, potassium

CITATION

Akça HŞ, Özdemir S, Özkan A, Küçüktürk S, Köse F. Evaluation of the effects of kidney function tests on prognosis and mortality in geriatric patients with a pulmonary embolism. J CLIN MED KAZ. 2022;19(5):23-7. https://doi.org/10.23950/jcmk/12503

REFERENCES

  • Le Gal G, Righini M, Roy PM, Meyer G, Aujesky D, Perrier A et al. Differential value of risk factors and clinical signs for diagnosing pulmonary embolism according to age. J Thromb Haemost. 2005; 3: 2457-64. https://doi.org/10.1111/j.1538-7836.2005.01598.x
  • Tatlısu MA, Kaya A, Keskin M, Avşar Ş, Bozbay M, Tatlisu K et al. The association of blood urea nitrogen levels with mortality in acute pulmonary embolism. Journal of Critical Care. 2017; 39:248–253. https://doi.org/10.1016/j.jcrc.2016.12.019
  • Robert-Ebadi H, Bertoletti L, Combescure C, Le Gal G, Bounameaux H, Righini M. Effects of impaired renal function on levels and performance of D-dimer in patients with suspected pulmonary embolism. Thromb Haemost. 2014; 112(03):614-620. https://doi.org/10.1160/TH13-12-1024
  • Akça HS, Köylü R, Akıllı NB, Isık KA, Köylü Ö, Cander B. Effect of Ionized Calcium Level on the Prognosis and Mortality of Patients with Pulmonary Embolism. American Journal of Internal Medicine. 2018;6(1):20-24. https://doi.org/10.11648/j.ajim.20180601.13
  • Babaoglu E, Hasanoğlu HC, Şentürk A, Karalezli A, Kiliç H, Aykun G et al. Importance of Biomarkers in Risk Stratification of Pulmonary Thromboembolism Patients. J Investig Med. 2014;62:328-31. https://doi.org/10.2310/JIM.0000000000000041
  • Kostrubiec M, Pływaczewska M, Jiménez D, Lankeit M, Ciurzynski M, Konstantinides S et al. The Prognostic Value of Renal Function in Acute Pulmonary Embolism—A Multi-Centre Cohort Study. Thromb Haemost. 2019; 119(01):140-8. https://doi.org/10.1055/s-0038-1676522
  • Baum N, Dichoso CC, Carlton CE. Blood urea nitrogen and serum creatinine. Urology. 1975;5(5):583-8. https://doi.org/10.1016/0090-4295(75)90105-3
  • Lindenfeld J, Schrier RW. Blood urea nitrogen. Journal of the American College of Cardiology. 2011;58(4):383-5. https://doi.org/10.1016/j.jacc.2011.01.054
  • Akça HŞ, Özdemir S, Algın A, Altunok İ. Comparison of geriatric pulmonary embolism severity index (G-PESI) with PESI and s-PESI in predicting prognosis and mortality. J Health Sci Med / JHSM. 2022; 5(2):676-681. https://doi.org/10.32322/jhsm.1070588
  • Zhu Y. Sasmita BR, Hu X, Xue Y, Gan H, Xiang Z et al. Blood Urea Nitrogen for Short-Term Prognosis in Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction. Hindawi International Journal of Clinical Practice. 2022. Article ID 9396088, 10 pages. https://doi.org/10.1155/2022/9396088
  • Kim H, Lee K, Choi HA, Samuel S, Park J H, Jo KW. Elevated Blood Urea Nitrogen/Creatinine Ratio Is Associated with Venous Thromboembolism in Patients with Acute Ischemic Stroke. Journal of Korean Neurosurgical Society. 2017;60(6):620-6. https://doi.org/10.3340/jkns.2016.1010.009
  • Chopard R, Piazza G, Falvo N, Ecarnot F, Besutti M, Capellier G et al. An Original Risk Score to Predict Early Major Bleeding in Acute Pulmonary Embolism: The Syncope, Anemia, Renal Dysfunction (PE-SARD) Bleeding Score. Chest. 2021;160(5):1832-43. https://doi.org/10.1016/j.chest.2021.06.048
  • Crisan A, Mıtu O, Costache II, Mıftode R, Haba CMS, Mıtu I et al. The Assessment of Biochemical Parameters in Patients with Venous Thromboembolism. Rev. Chim. 2020;71(4):594-600. https://doi.org/10.37358/RC.20.4.8100
  • Akgüllü Ç, Ömürlü İK, Eryılmaz U, Avcil M, Dağtekin E, Akdeniz M et al. Predictors of early death in patients with acute pulmonary embolism. The American Journal of Emergency Medicine. 2015;33(2):214-21. https://doi.org/10.1016/j.ajem.2014.11.022
  • Altınsoy B, Öz İİ, Örnek T, Erboy F, Tanrıverdi H, Uygur F, Altıntaş N, Atalay F, Tor MM. Prognostic Value of Renal Dysfunction Indicators in Normotensive Patients With Acute Pulmonary Embolism. Clinical and Applied Thrombosis/Hemostasis. 2016;23(6):554-61. https://doi.org/10.1177/1076029616637440
  • Fabbian F, Gallerani M, Pala M, De Giorgi A, Salmi R, Manfredini F et al. In-hospital mortality for pulmonary embolism: relationship with chronic kidney disease and end-stage renal disease. The hospital admission and discharge database of the Emilia Romagna region of Italy. Intern Emerg Med.2013;8:735-40 (2013). https://doi.org/10.1007/s11739-012-0892-8
  • Xing X, Liu J, Deng Y, Xu S, Wei L, Yang M et al. Impact of renal function on the prognosis of acute pulmonary embolism patients: a systematic review and meta-analysis. Expert Review of Respiratory Medicine. 2020;16(1):91-8. https://doi.org/10.1080/17476348.2021.1862653
  • Jiménez D, Aujesky D, Moores L, Gomez V, Lobo JL, Uresandi F et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383-9. https://doi.org/10.1001/archinternmed.2010.199
  • Aquet E, Tritschler T, Stalder O, Limacher A, Mean M, Rodondi N et al. Prediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score. J Thromb Haemost 2018;16(7):1313-20. https://doi.org/10.1111/jth.14137