AbstractEvidence for the prognostic impact of chest pain in acute pulmonary embolism (APE) is limited. This study aimed to assess the prognostic value of chest pain in a Chinese cohort of patients with APE. Consecutive hospitalized patients diagnosed with APE between January 2016 and December 2019 were retrospectively enrolled and followed prospectively for 2 years at West China Hospital of Sichuan University.

摘要胸痛对急性肺栓塞（APE）预后影响的证据有限。本研究旨在评估中国APE患者队列中胸痛的预后价值。回顾性纳入2016年1月至2019年12月期间被诊断为APE的连续住院患者，并在四川大学华西医院进行前瞻性随访2年。

The primary outcome was in-hospital all- cause mortality, while the secondary outcomes included 3-month, 6-month, and 2-year all-cause mortality, APE recurrence, mechanical ventilation, and length of hospital stay (LOS). A total of 737 APE patients met the study criteria, with 254 patients (34.5%) presented with chest pain at admission.

主要终点是院内全因死亡率，而次要终点包括3个月，6个月和2年全因死亡率，APE复发，机械通气和住院时间（LOS）。共有737名APE患者符合研究标准，其中254名患者（34.5%）在入院时出现胸痛。

Patients with chest pain had significantly lower in-hospital (3.1% vs. 11.2%), 3-month (3.7% vs. 7.5%), 6-month (5.3% vs. 10.0%), and 2-year (9.8% vs. 15.4%) all-cause mortality compared to patients without chest pain (all P < 0.05). A lower rate of mechanical ventilation was observed in APE patients with chest pain, and no significant differences were identified in terms of APE recurrence and LOS between APE patients with and without chest pain.

胸痛患者的院内死亡率（3.1%比11.2%），3个月（3.7%比7.5%），6个月（5.3%比10.0%）和2年（9.8%比15.4%）明显低于无胸痛患者（均P<0.05）。在患有胸痛的APE患者中观察到较低的机械通气率，并且在患有和不患有胸痛的APE患者之间，在APE复发和LOS方面没有发现显着差异。

Chest pain was an independent predictor of in-hospital mortality in three separate multivariable models (range of odds ratios 0.390–0.423, all P < 0.05). APE patients with chest pain had a lower short-term and long-term all-cause mortality compared to those without chest pain. Chest pain may be considered a strong, favorable prognostic marker in acute pulmonary embolism..

在三个独立的多变量模型中，胸痛是院内死亡率的独立预测因子（优势比范围为0.390-0.423，均P<0.05）。与没有胸痛的患者相比，患有胸痛的APE患者的短期和长期全因死亡率较低。胸痛可能被认为是急性肺栓塞的一个强有力的、有利的预后指标。。

IntroductionAcute pulmonary embolism (APE) is a common, life-threatening cardiovascular disease, with a reported incidence of 60 to 120 cases per 100 000 population per year in Western countries1,2. Despite remarkable advances in diagnosis and management, APE remains the third most common cause of death from cardiovascular disease, only behind myocardial infarction and stroke3.

引言急性肺栓塞（APE）是一种常见的危及生命的心血管疾病，据报道，西方国家每年每10万人中有60至120例发病率1,2。尽管在诊断和管理方面取得了显着进展，但APE仍然是心血管疾病死亡的第三大常见原因，仅次于心肌梗塞和中风3。

In the United States, approximately 60 per 100 000 patients die of APE each year2,4. In China, 343 deaths were reported among 8789 patients hospitalized for APE, corresponding to an in-hospital mortality of 3.9%5. The hospitalization rate of APE is increasing annually, which imposes a substantial burden on the healthcare system5,6.

在美国，每年约有60/10万患者死于APE 2,4。在中国，8789例APE住院患者中报告了343例死亡，相当于3.9%的院内死亡率5。APE的住院率每年都在增加，这给医疗保健系统带来了沉重的负担5,6。

Current guidelines recommend APE patients with low risk of death may be discharged early from hospital and managed in an outpatient setting7,8. It is therefore essential to identify APE patients at low risk of mortality.Chest pain is one of the most frequent symptoms of patients with APE, with a reported prevalence varies from 19–59%9,10,11,12.

目前的指南建议，死亡风险低的APE患者可能会尽早出院，并在门诊进行管理7,8。因此，确定死亡率低的APE患者至关重要。胸痛是APE患者最常见的症状之一，据报道患病率在19-59%之间9,10,11,12。

In the EMPEROR study, a prospective and multicenter registry in the United States, the proportion of patients with chest pain was 39.4% among those with confirmed pulmonary embolism11. According to an Italian registry, 321(19%) patients with APE reported pleuritic chest pain12. Several studies have found that clinical symptoms were linked to the severity and prognosis of APE13,14,15,16.

在美国的一项前瞻性多中心注册研究EMPERON研究中，确诊肺栓塞患者中胸痛患者的比例为39.4%11。根据意大利登记处的数据，321名（19%）APE患者报告了胸膜炎性胸痛12。几项研究发现，临床症状与APE13,14,15,16的严重程度和预后有关。

However, the relationship between chest pain and mortality has not been established precisely. Wong et al. found that chest pain occurred in 771 (59%) patients and chest pain was an advantageous prognostic marker for APE patients in Australia9. It remains unclear whether the presence of chest pain has any impact on mortality in Asian patients wit.

然而，胸痛与死亡率之间的关系尚未确切确定。Wong等人发现，771例（59%）患者出现胸痛，胸痛是澳大利亚APE患者的有利预后指标9。。

Data availability

数据可用性

The original data of this manuscript are available on reasonable request by contacting the correspondence author.

如果有合理的要求，可以通过联系通讯作者获得本手稿的原始数据。

ReferencesYoo, H. H., Nunes-Nogueira, V. S., Fortes Villas Boas, P. J. & Broderick, C. Outpatient versus inpatient treatment for acute pulmonary embolism. Cochrane Database Syst. Rev. 5, Cd010019. https://doi.org/10.1002/14651858.CD010019.pub4 (2022).Article

ReferencesYoo，H.H.，Nunes Nogueira，V.S.，Fortes Villas Boas，P.J。＆Broderick，C。急性肺栓塞的门诊与住院治疗。Cochrane数据库系统。第5版，Cd010019。https://doi.org/10.1002/14651858.CD010019.pub4（2022年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Freund, Y., Cohen-Aubart, F. & Bloom, B. Acute pulmonary embolism: A review. Jama 328, 1336–1345. https://doi.org/10.1001/jama.2022.16815 (2022).Article

Freund，Y.，Cohen-Aubart，F。＆Bloom，B。急性肺栓塞：综述。Jama 3281336-1345。https://doi.org/10.1001/jama.2022.16815（2022年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Jiménez, D. et al. Trends in the management and outcomes of acute pulmonary embolism: Analysis from the RIETE registry. J. Am. Coll Cardiol. 67, 162–170. https://doi.org/10.1016/j.jacc.2015.10.060 (2016).Article

Jiménez，D.等人，《急性肺栓塞的治疗和预后趋势：来自RIETE登记处的分析》。J、 Am。Coll Cardiol。67162-170。https://doi.org/10.1016/j.jacc.2015.10.060（2016年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Virani, S. S. et al. Heart disease and stroke statistics-2020 update: A report from the American heart association. Circulation 141, e139–e596. https://doi.org/10.1161/cir.0000000000000757 (2020).Article

Virani，S.S.等人，《心脏病和中风统计-2020年更新：美国心脏协会的报告》。发行量141，e139–e596。https://doi.org/10.1161/cir.0000000000000757（2020年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Zhang, Z. et al. Trends in hospitalization and in-hospital mortality from VTE, 2007 to 2016. China. Chest 155, 342–353. https://doi.org/10.1016/j.chest.2018.10.040 (2019).Article

Zhang，Z.等人。2007年至2016年VTE住院和院内死亡率的趋势。中国。胸部155342-353。https://doi.org/10.1016/j.chest.2018.10.040（2019年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Peacock, W. F. & Singer, A. J. Reducing the hospital burden associated with the treatment of pulmonary embolism. J. Thromb. Haemost. 17, 720–736. https://doi.org/10.1111/jth.14423 (2019).Article

Peacock，W.F。＆Singer，A.J。减轻与肺栓塞治疗相关的医院负担。J、 血栓。血友病。1720-736年。https://doi.org/10.1111/jth.14423（2019年）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Konstantinides, S. V. et al. ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology.

Konstantinides，S.V.等人。ESC急性肺栓塞诊断和管理指南是与欧洲呼吸学会（ERS）合作制定的：欧洲心脏病学会急性肺栓塞诊断和管理工作组。

Eur. Respir. J. https://doi.org/10.1183/13993003.01647-2019 (2019).Article .

Eur. Respir. J. https://doi.org/10.1183/13993003.01647-2019 (2019).Article .

PubMed

PubMed

Google Scholar

谷歌学者

Stevens, S. M. et al. Antithrombotic therapy for VTE disease: Second update of the CHEST guideline and expert panel report. Chest 160, e545–e608. https://doi.org/10.1016/j.chest.2021.07.055 (2021).Article

Stevens，S.M.等人，《VTE疾病的抗血栓治疗：胸部指南和专家小组报告的第二次更新》。胸围160，e545–e608。https://doi.org/10.1016/j.chest.2021.07.055（2021年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Wong, C. C. et al. The prognostic impact of chest pain in 1306 patients presenting with confirmed acute pulmonary embolism. Int. J. Cardiol. 221, 794–799. https://doi.org/10.1016/j.ijcard.2016.07.129 (2016).Article

Wong，C.C.等人。1306例确诊急性肺栓塞患者胸痛的预后影响。国际心脏病杂志。221794-799。https://doi.org/10.1016/j.ijcard.2016.07.129（2016年）。文章

ADS

广告

PubMed

PubMed

Google Scholar

谷歌学者

Lobo, J. L. et al. Clinical syndromes and clinical outcome in patients with pulmonary embolism: Findings from the RIETE registry. Chest 130, 1817–1822. https://doi.org/10.1378/chest.130.6.1817 (2006).Article

Lobo，J.L.等人。肺栓塞患者的临床综合征和临床结果：来自RIETE登记处的发现。胸1301817-1822。https://doi.org/10.1378/chest.130.6.1817（2006年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Pollack, C. V. et al. Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J. Am. Coll. Cardiol. 57, 700–706.

Pollack，C.V.等人。急诊科诊断为急性肺栓塞患者的临床特征，管理和结果：EMPERON的初步报告（现实世界登记处的多中心急诊医学肺栓塞）。J、 美国科罗拉多州。心脏病。57700–706。

https://doi.org/10.1016/j.jacc.2010.05.071 (2011).Article .

https://doi.org/10.1016/j.jacc.2010.05.071 (2011).Article .

PubMed

PubMed

Google Scholar

谷歌学者

Casazza, F. et al. Clinical features and short term outcomes of patients with acute pulmonary embolism. The Italian Pulmonary Embolism Registry (IPER). Thromb. Res. 130, 847–852. https://doi.org/10.1016/j.thromres.2012.08.292 (2012).Article

Casazza，F。等人。急性肺栓塞患者的临床特征和短期预后。意大利肺栓塞登记处（IPER）。血栓。。https://doi.org/10.1016/j.thromres.2012.08.292（2012年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Roncon, L. et al. Impact of syncope and pre-syncope on short-term mortality in patients with acute pulmonary embolism. Eur. J. Intern. Med. 54, 27–33. https://doi.org/10.1016/j.ejim.2018.04.004 (2018).Article

Roncon，L.等人。晕厥和晕厥前期对急性肺栓塞患者短期死亡率的影响。Eur.J.实习生。医学54，27-33。https://doi.org/10.1016/j.ejim.2018.04.004（2018年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Stein, P. D., Willis, P. W. 3rd. & DeMets, D. L. History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease. Am. J. Cardiol. 47, 218–223. https://doi.org/10.1016/0002-9149(81)90388-x (1981).Article

斯坦，P.D.，威利斯，P.W.第三和。美国心脏病杂志。47218-223。https://doi.org/10.1016/0002-9149（81）90388-x（1981）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

de Winter, M. A. et al. The prognostic value of syncope on mortality in patients with pulmonary embolism: A systematic review and meta-analysis. Ann. Emerg. Med. 76, 527–541. https://doi.org/10.1016/j.annemergmed.2020.03.026 (2020).Article

de Winter，M.A.等。晕厥对肺栓塞患者死亡率的预后价值：系统评价和荟萃分析。。https://doi.org/10.1016/j.annemergmed.2020.03.026（2020年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Saad, M. et al. Fever is associated with higher morbidity and clot burden in patients with acute pulmonary embolism. BMJ Open Respir. Res. 5, e000327. https://doi.org/10.1136/bmjresp-2018-000327 (2018).Article

Saad，M。等人。发热与急性肺栓塞患者的发病率和凝块负担较高有关。BMJ开放呼吸。第5号决议，e000327。https://doi.org/10.1136/bmjresp-2018-000327（2018年）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Jiménez, D. et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch. Intern. Med. 170, 1383–1389. https://doi.org/10.1001/archinternmed.2010.199 (2010).Article

Jiménez，D。等人。简化肺栓塞严重程度指数，用于急性症状性肺栓塞患者的预后。拱门。实习生。医学1701383-1389。https://doi.org/10.1001/archinternmed.2010.199（2010年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Charlson, M. E., Pompei, P., Ales, K. L. & MacKenzie, C. R. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic Dis. 40, 373–383. https://doi.org/10.1016/0021-9681(87)90171-8 (1987).Article

Charlson，M.E.，Pompei，P.，Ales，K.L。＆MacKenzie，C.R。纵向研究中预后合并症分类的新方法：开发和验证。J、 慢性疾病。40373-383。https://doi.org/10.1016/0021-9681（87）90171-8（1987）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Bass, C. & Mayou, R. Chest pain. Bmj 325, 588–591. https://doi.org/10.1136/bmj.325.7364.588 (2002).Article

Bass，C.和Mayou，R.胸痛。英国医学杂志325588-591。https://doi.org/10.1136/bmj.325.7364.588(2002).文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Gulati, M. et al. AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circulation 144, e368–e454. https://doi.org/10.1161/cir.0000000000001029 (2021).Article .

。循环144，e368–e454。https://doi.org/10.1161/cir.0000000000001029（2021年）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Oranu, A. C. & Vaezi, M. F. Noncardiac chest pain: Gastroesophageal reflux disease. Med. Clin. North Am. 94, 233–242. https://doi.org/10.1016/j.mcna.2010.01.001 (2010).Article

Oranu，A.C。和Vaezi，M.F。非心源性胸痛：胃食管反流病。医学临床。北安普敦94233-242。https://doi.org/10.1016/j.mcna.2010.01.001（2010年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Xi, L. et al. A machine learning model for diagnosing acute pulmonary embolism and comparison with Wells score, revised Geneva score, and Years algorithm. Chin. Med. J. (Engl) https://doi.org/10.1097/cm9.0000000000002837 (2023).Article

Xi，L.等人。用于诊断急性肺栓塞的机器学习模型，并与Wells评分，修订的Geneva评分和Years算法进行比较。下巴。医学杂志（英语）https://doi.org/10.1097/cm9.0000000000002837（2023年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Stein, P. D. & Henry, J. W. Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest 112, 974–979. https://doi.org/10.1378/chest.112.4.974 (1997).Article

Stein，P.D.＆Henry，J.W。急性肺栓塞患者的临床特征根据其表现综合征进行分层。胸部112974-979。https://doi.org/10.1378/chest.112.4.974（1997年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Konstantinides, S. V. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur. Heart J. 41, 543–603. https://doi.org/10.1093/eurheartj/ehz405 (2020).Article

Konstantinides，S.V.等人2019年与欧洲呼吸学会（ERS）合作制定的ESC急性肺栓塞诊断和管理指南。《欧洲心脏杂志》41543-603。https://doi.org/10.1093/eurheartj/ehz405（2020年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Hultcrantz, M. et al. Hemoglobin concentration and risk of arterial and venous thrombosis in 1.5 million Swedish and Danish blood donors. Thromb. Res. 186, 86–92. https://doi.org/10.1016/j.thromres.2019.12.011 (2020).Article

Hultcrantz，M.等人。150万瑞典和丹麦献血者的血红蛋白浓度和动静脉血栓形成风险。血栓。第186、86-92号决议。https://doi.org/10.1016/j.thromres.2019.12.011（2020年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Shi, J. et al. Circadian nuclear receptor Rev-erbα is expressed by platelets and potentiates platelet activation and thrombus formation. Eur. Heart J. 43, 2317–2334. https://doi.org/10.1093/eurheartj/ehac109 (2022).Article

Shi，J。等人。昼夜节律核受体Rev-erbα由血小板表达，并增强血小板活化和血栓形成。欧洲心脏杂志432317-2334。https://doi.org/10.1093/eurheartj/ehac109（2022年）。文章

CAS

中科院

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Rezania, S. et al. Platelet hyperactivation, apoptosis and hypercoagulability in patients with acute pulmonary embolism. Thromb. Res. 155, 106–115. https://doi.org/10.1016/j.thromres.2017.05.009 (2017).Article

Rezania，S。等。急性肺栓塞患者的血小板过度活化，细胞凋亡和高凝状态。血栓。第155106-115号决议。https://doi.org/10.1016/j.thromres.2017.05.009（2017年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Kaptein, F. H. J. et al. Pulmonary infarction in acute pulmonary embolism. Thromb. Res. 202, 162–169. https://doi.org/10.1016/j.thromres.2021.03.022 (2021).Article

Kaptein，F.H.J.等。急性肺栓塞中的肺梗塞。血栓。第202、162-169号决议。https://doi.org/10.1016/j.thromres.2021.03.022（2021年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Goldhaber, S. Z., Visani, L. & De Rosa, M. Acute pulmonary embolism: Clinical outcomes in the international cooperative pulmonary embolism registry (ICOPER). Lancet 353, 1386–1389. https://doi.org/10.1016/s0140-6736(98)07534-5 (1999).Article

Goldhaber，S.Z.，Visani，L。和De Rosa，M。急性肺栓塞：国际合作肺栓塞登记处（ICOPER）的临床结果。柳叶刀3531386-1389。https://doi.org/10.1016/s0140-6736（98）07534-5（1999）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Aujesky, D. et al. Derivation and validation of a prognostic model for pulmonary embolism. Am. J. Respir. Crit. Care Med. 172, 1041–1046. https://doi.org/10.1164/rccm.200506-862OC (2005).Article

Aujesky，D。等人。肺栓塞预后模型的推导和验证。Am.J.Respir。暴击。护理医学1721041-1046。https://doi.org/10.1164/rccm.200506-862OC（2005年）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

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Download referencesAcknowledgementsThanks to all authors for their contributions to this manuscript.FundingThis study was supported by the National Natural Science Foundation of China (82170013), the Sichuan Science and Technology Program (2022YFS0262).Author informationAuthor notesJiarui Zhang and Haitao Zou contributed equally to this work.Authors and AffiliationsDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Guo-xue-xiang 37#, Wuhou District, Chengdu, 610041, Sichuan Province, ChinaJiarui Zhang, Yongjiang Tang, Lige Peng, Jiaqi Pu, Jiaxin Zeng, Xueqing Chen, Jianlin Yuan, Qun Yi & Haixia ZhouDepartment of Respiratory and Critical Care Medicine, Dianjiang People’s Hospital of Chongqing, Chongqing Province, ChinaHaitao ZouSichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, ChinaQun YiAuthorsJiarui ZhangView author publicationsYou can also search for this author in.

下载参考文献致谢感谢所有作者对本手稿的贡献。资助该研究得到了国家自然科学基金（82170013），四川省科学技术计划（2022YFS0262）的支持。作者信息作者注张佳瑞和邹海涛对这项工作做出了同样的贡献。作者和附属机构四川大学华西医院呼吸与重症医学科，四川省成都市武侯区国学巷37#，610041，中国张家瑞，唐永江，彭立格，蒲家琦，曾家欣，陈雪清，袁建林，群宜和周海霞重庆市垫江人民医院呼吸与重症医学科，中国电子科技大学邹思川癌症医院，四川省成都市，中国群宜作者张睿查看作者出版物您也可以在中搜索此作者。

PubMed Google ScholarHaitao ZouView author publicationsYou can also search for this author in

PubMed谷歌学者Haitao ZouView作者出版物您也可以在

PubMed Google ScholarYongjiang TangView author publicationsYou can also search for this author in

PubMed Google ScholaryYongjiang TangView作者出版物您也可以在

PubMed Google ScholarLige PengView author publicationsYou can also search for this author in

PubMed Google ScholarLige PengView作者出版物您也可以在

PubMed Google ScholarJiaqi PuView author publicationsYou can also search for this author in

PubMed Google ScholarJiaqi PuView作者出版物您也可以在

PubMed Google ScholarJiaxin ZengView author publicationsYou can also search for this author in

PubMed Google ScholarJiaxin ZengView作者出版物您也可以在

PubMed Google ScholarXueqing ChenView author publicationsYou can also search for this author in

PubMed谷歌学者陈雪清查看作者出版物您也可以在

PubMed Google ScholarJianlin YuanView author publicationsYou can also search for this author in

PubMed Google ScholarJianlin YuanView作者出版物您也可以在

PubMed Google ScholarQun YiView author publicationsYou can also search for this author in

PubMed Google ScholarHaixia ZhouView author publicationsYou can also search for this author in

PubMed谷歌学者Haixia Zhou查看作者出版物您也可以在

PubMed Google ScholarContributionsJ.Z. and H.Z. contributed to the curation and analysis of the data and drafted the manuscript. H.Z. and Q.Y. contributed to the design of the study and revised or critically reviewed the article. Y.T., L.P., J.P., J.Z., X.C., and J.Y. all contributed to the acquisition and interpretation of the data and gave final approval of the version to be published.Corresponding authorsCorrespondence to.

PubMed谷歌学术贡献。Z、 H.Z.为数据的整理和分析做出了贡献，并起草了手稿。H、 Z.和Q.Y.为研究的设计做出了贡献，并对文章进行了修订或批判性审查。Y、 T.，L.P.，J.P.，J.Z.，X.C。和J.Y.都为数据的获取和解释做出了贡献，并最终批准了要发布的版本。通讯作者通讯。

Qun Yi or Haixia Zhou.Ethics declarations

群毅或周海霞。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Ethics approval and consent to participate

道德批准和同意参与

This study was approved by the institutional review board of the West China Hospital of Sichuan University in accordance with the Declaration of Helsinki. The informed consent was waived by the Ethics Review Committee of West China Hospital of Sichuan University.

根据赫尔辛基宣言，这项研究得到了四川大学华西医院机构审查委员会的批准。四川大学华西医院伦理审查委员会放弃了知情同意。

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Reprints and permissionsAbout this articleCite this articleZhang, J., Zou, H., Tang, Y. et al. Impact of chest pain on mortality in patients with acute pulmonary embolism.

转载和许可本文引用本文Zhang，J.，Zou，H.，Tang，Y。等人。胸痛对急性肺栓塞患者死亡率的影响。

Sci Rep 14, 30038 (2024). https://doi.org/10.1038/s41598-024-81520-wDownload citationReceived: 14 May 2024Accepted: 27 November 2024Published: 03 December 2024DOI: https://doi.org/10.1038/s41598-024-81520-wShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1430038（2024）。https://doi.org/10.1038/s41598-024-81520-wDownload引文接收日期：2024年5月14日接受日期：2024年11月27日发布日期：2024年12月3日OI：https://doi.org/10.1038/s41598-024-81520-wShare本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsAcute pulmonary embolismChest painPrognostic marker

关键词急性肺栓塞最大疼痛预后标志物