Facilitating factors of venous risk among patients diagnosed with pulmonary thromboembolism followed in different clinical settings

Aims: This study aims to analyze the risk factors contributing to the development of pulmonary thromboembolism (PTE) from a multidisciplinary perspective, focusing on clinical, demographic, and laboratory variables that may influence venous thrombosis pathogenesis. By elucidating the interrelationships among these factors, the study seeks to support preventive strategies and provide a scientific basis for diagnostic and management processes. Methods: This study was conducted through a systematic evaluation of the diagnostic data—including clinical, laboratory, and imaging findings—of individuals aged 18 to 80 years who were followed for pulmonary thromboembolism between 2023 and 2025 at the Chest Diseases, Cardiovascular Surgery, and Internal Medicine departments of xxx xxx University Research and Training Hospital. Patients with uncertain diagnoses, individuals under 18 years of age, and those who received only prophylactic treatment were excluded. Imaging data (thoracic CT angiography, scintigraphy, abdominal CT, and venous Doppler ultrasound) were analyzed based on prior reports without performing any additional procedures. Clinical variables such as smoking status, comorbid conditions, surgical history, immobility, and hormonal factors in female patients, along with laboratory parameters including complete blood count, biochemistry, blood gas analysis, and D-dimer levels, were reviewed retrospectively. Results: A total of 41 patients (25 female, 16 male) diagnosed with PTE were evaluated. The mean age of participants was 61.59 ± 17.92 years. The average age was 62.56 ± 17.93 years in women and 60.06 ± 18.40 years in men. Among 11 patients with available data on body mass index (BMI), the mean BMI was 29.97 ± 3.05. Of these, 5 were overweight, 5 had class 1 obesity, and 1 had class 2 obesity. The most common comorbidities included hypertension (n=24), diabetes mellitus (n=10), coronary artery disease (n=7), and hyperlipidemia (n=4). Among the 4 smokers, the average consumption was calculated as 21 pack-years. Surgical history was present in 17.1% of cases, and a history of immobilization was identified in 14.6%. Malignancy was observed in 2.4%, history of pregnancy in 4.9%, and oral contraceptive use in 2.4% of the patients. Genetic mutations related to hereditary thrombophilia were found in 19.5% of patients. Laboratory analyses revealed a mean hemoglobin level of 13.25 ± 2.12 g/dL, significantly lower than the reference range (p = 0.0225). Blood urea nitrogen (BUN) was elevated, with a mean level of 27.16 ± 10.43 mg/dL (p = 0.0004). Arterial blood gas analysis showed a mean sO² of 74.92 ± 12.35%, pO² of 52.21 ± 10.87 mmHg, and pCO² of 30.26 ± 6.14 mmHg, all significantly below normal reference values (p < 0.0001). The mean D-dimer level was 3.31 ± 2.36 µg/mL (p < 0.001). According to CT angiography, bilateral embolism was observed in 15 patients, segmental/lobar embolism in 14, and multiple emboli in 12. Deep vein thrombosis (DVT) was detected in 4 patients via Doppler ultrasound, while 21 patients showed no evidence of DVT. Conclusion: This study underscores the multifactorial etiopathogenesis of pulmonary thromboembolism and emphasizes the importance of a personalized and holistic evaluation approach in diagnosis and treatment. Risk factors such as age, obesity, comorbidities, surgical history, immobility, and genetic predisposition were shown to be significant contributors to PTE development. Low hemoglobin levels and marked hypoxemia-hypocapnia reflected the systemic impact of the condition, while elevated D-dimer levels and CT angiography findings played a crucial role in early diagnosis. The findings highlight that integrating clinical, laboratory, and radiological data within a multidisciplinary framework can enhance risk stratification and improve patient outcomes.