Authors
Peng Jiang, Jiawei Fan, Wenfei Guan, Yongpan Cui, Zihan Zhang, Jian He, Fei Mei
Published in
Phlebology. Pages 2683555261499772. Oct 18, 2026. Epub Oct 18, 2026.
Abstract
ObjectivesTo compare the clinical characteristics, risk factors, and prognosis of incidental pulmonary embolism (IPE) and symptomatic pulmonary embolism (SPE), and to inform risk-stratified management.MethodsThis retrospective study analyzed 287 patients with hospital-acquired pulmonary embolism (HA-PE). Demographic, clinical, imaging, and laboratory data were collected. Survival outcomes were assessed using Cox regression and Kaplan-Meier analyses.ResultsAmong 287 patients, 87 had IPE and 200 had SPE. IPE was more frequently classified as low-risk PE (63.22% vs. 31.50%, p < 0.001) and more often involved pulmonary artery branches (73.56% vs. 58.00%, p = 0.01), whereas SPE was more commonly intermediate- or high-risk. The 1-month survival rate was higher in the IPE group than in the SPE group (95.4% vs. 75.5%, hazard ratio [HR]: 5.95, 95% confidence interval [CI]: 2.51 - 16.5, p < 0.001), but this difference was not significant after 1 month. In IPE, cancer and bleeding were associated with increased mortality, whereas anticoagulation and lower PE risk categories were associated with reduced mortality. In SPE, cancer and immobilization were associated with increased mortality, whereas anticoagulation, thrombectomy, and lower PE risk categories were associated with reduced mortality.ConclusionsIPE is generally associated with lower-risk, more peripheral PE, but anticoagulation should be individualized. SPE requires prompt risk stratification and timely anticoagulation, with reperfusion or thrombectomy considered for selected high-risk or deteriorating patients.
PMID:
42893388
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.
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