A Retrospective Assessment of Clinical Risk Factors Associated with Pulmonary Embolism

Abstract

Background: Pulmonary embolism (PE) is a serious and potentially life-threatening cardiovascular condition, significantly contributing to global morbidity and mortality. Despite increasing recognition in sub-Saharan Africa, particularly in Nigeria, limited context-specific data on its clinical profile and risk factors continues to hinder effective diagnosis and management. Aims: This study describes the demographic characteristics, clinical presentation, risk factors, comorbidities, and in-hospital outcomes of patients managed for pulmonary embolism (PE) in a Nigerian cohort. Study Design: This study utilized a retrospective descriptive and analytical design. Place and Duration of Study: Department of Internal Medicine, Nisa-Garki Hospital. Data were collected retrospectively from the medical records of patients admitted to the hospital between April 2020 and September 2025. Methodology: A descriptive analysis was conducted among 62 patients with confirmed PE. Data on demographics, presenting symptoms, risk factors, co-morbidities, length of hospital stay, and in-hospital mortality were collected and analyzed, with stratification by gender. Results: The cohort was predominantly middle-aged, with a mean age of 51.0 ± 14.8 years, and was female-predominant (57%). Breathlessness was the most common presenting symptom (79%), followed by chest pain (45%) and cough (31%), with no significant gender-related differences. Immobilization was the most prevalent risk factor (45%), followed by recent surgery (24%) and previous deep vein thrombosis or pulmonary embolism (13%). Hypertension was the most frequent comorbidity (35%), while heart failure (19%) showed a marked female predominance. Overall, in-hospital mortality was 13% (8/62), with the highest mortality observed among patients with heart failure (25%) and malignancy (20%). Heart failure demonstrated the strongest association with mortality (crude OR 3.4), although it was not statistically significant due to the small number of events. The mean hospital stay was 15.5 days, with longer stays among females and among patients with heart failure or immobilization. Overall survival was 87%. Conclusion: In this cohort, PE predominantly affected middle-aged adults, with modifiable risk factors, particularly immobilization, being highly prevalent. Heart failure emerged as the principal determinant of mortality and prolonged hospitalization, likely reflecting reduced cardiopulmonary reserve.