Prognosis of Postoperative Pulmonary Embolism in High Altitude

Background: Pulmonary embolism (PE) is a common cause of death and serious disability, with risks that extend beyond the acute phase. Despite advances in diagnosis and treatment, high mortality rates remain a persistent problem.

Aim: The current study aimed to investigate PE prognosis and its determinants among native highlanders in Taif City, Saudi Arabia.

Methods: This is a retrospective study where data was collected from the medical records of native high-altitude PE patients in Taif, Saudi Arabia, from 2017 to 2022.

Results: The study included 154 native high-altitude PE patients with a mean age of 54±19 years. Most were females and nonsmokers (51.3% (n=79) and 89% (n=137), respectively). Of them, 28.6% (n=44) had undergone a previous surgery, and 61.4% (n=27) of these surgeries were within 1-3 weeks before hospital admission. The majority of patients had sub-massive PE (59.1% (n=91)), followed by non-massive PE (24% (n=37)) and massive PE (16.9% (n=26)). After management, 98 (63.6%) patients were improved, and 56 (36.4%) patients were not improved at the time of data collection. In terms of improvement after PE, patients who had undergone a previous surgery were less than those who had not, with no significant difference (56.8% (n=25) and 66.4% (n=73), respectively, p=0.266). All patients with heart rates (HRs) less than 70 bpm improved after PE compared to those with higher HRs (p=0.003). The thrombus location had no statistically significant association with patient outcomes (p=0.058).

Conclusion: This study provides valuable insights into patient outcomes at high altitudes after PE and the prognostic factors influencing these outcomes. It was identified that a low HR was associated with positive outcomes.