Study on the risk factors of international normalized ratio instability in patients with pulmonary embolism

Tian Chunying; Gao Na; Xu Mingying; Li Yajing; Wang Xifu

doi:10.3760/j.issn.1673-4777.2024.08.011

Abstract：Objective To analyze the relevant factors affecting the instability of international normalized ratio(INR)in patients with pulmonary embolism,and to construct a nomogram prediction model and verify it.Method A retrospective analysis was performed on 562 patients with pulmonary embolism admitted to Beijing Anzhen Hospital,Capital Medical University from January 2017 to August 2022.Patients were divided into INR instability group(47 cases)and INR stability group(515 cases).The clinical data of the two groups were compared.The influencing factors of INR instability in patients with pulmonary embolism were analyzed by Logistic regression method and verified by receiver operating characteristic(ROC)curve.Results There were significant differences in gender ratio,body mass index,total bilirubin level and the proportions of active tumor,infection,heart failure,lower limb swelling,rheumatic heart disease,hypertension and anemia between the two groups(all P＜0.05).Logistic regression analysis showed that male(odds ratio=2.94,95％confidence interval:1.41-6.13,P＜0.01),rheumatic heart disease(odds ratio=17.70,95％confidence interval:2.78-112.64,P＜0.01),anemia(odds ratio=7.76,95％confidence interval:3.37-17.87,P＜0.01)were risk factors for INR instability in patients with pulmonary embolism.ROC curve analysis showed that the area under the curve of male,rheumatic heart disease and anemia to predict INR instability was 0.787.Conclusions Gender,rheumatic heart disease and anemia are independently correlated with INR instability in patients with pulmonary embolism,and the combined prediction of INR instability is better than that of a single index,which is a good reference value for medical staff in clinical practice.