ArticleMedicine2026
Characteristics and prognostic factors of patients with community-acquired pneumonia combined with pulmonary embolism: A prospective cohort study.
Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Pulmonary embolism (PE) is a frequently missed complication in elderly patients with community-acquired pneumonia (CAP), partly due to overlapping clinical features. This study aimed to identify early indicators for PE detection in this population. A prospective cohort of 180 elderly CAP patients (≥60 years) admitted between March 2023 and July 2024 was enrolled. Patients with elevated D‑dimer (>0.50 mg/L) underwent computed tomography pulmonary angiography (CTPA). Of 140 CTPA-evaluated patients, 80 had CAP+PE and 60 had CAP alone. Demographics, comorbidities, symptoms, and laboratory parameters (D‑dimer, fibrinogen, CRP, PCT) were compared, and diagnostic performance was assessed using receiver operating characteristic curves. The CAP+PE group was older (71.35 ± 5.04 vs. 69.03 ± 4.57 years; P <.05) and had higher rates of hypertension (65% vs. 40%), coronary artery disease (48% vs. 25%), chronic obstructive pulmonary disease (55% vs. 30%), cancer (35% vs. 15%), diabetes (50% vs. 28%), and long-term bedridden status (38% vs. 18%) (all P <.05). Syncope (28% vs. 8%), chest pain (45% vs. 20%), and dyspnea (75% vs. 55%) were more prevalent in CAP+PE (P <.05). D‑dimer (median [IQR]: 4.2 [2.8-6.1] mg/L vs. 1.9 [1.1-2.7] mg/L) and fibrinogen (4.1 ± 1.2 g/L vs. 3.3 ± 0.9 g/L) were significantly elevated in CAP+PE (P <.05). ROC analysis showed D‑dimer (cutoff 3.13 mg/L) had moderate diagnostic accuracy (AUC 0.73; sensitivity 81%, specificity 63%), while fibrinogen (cutoff 2.79 g/L) had lower accuracy (AUC 0.68). Elevated D‑dimer (>3.13 mg/L) serves as a practical screening tool for PE in elderly CAP patients, particularly in resource-limited settings lacking CTPA; high-risk comorbidities and atypical symptoms (syncope/chest pain) further support early PE evaluation.
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