Risk Factors and Long-Term Outcomes of Pulmonary Embolism: A Prospective Follow-Up Study from Swat, Pakistan

Abstract

Objectives: This study aimed to determine the baseline risk factors and long-term clinical outcomes of patients with pulmonary embolism (PE) presenting to a tertiary cardiology department in Swat, Khyber Pakhtunkhwa, Pakistan. Methodology: A prospective cross-sectional follow-up study was conducted among 60 patients diagnosed with PE between April 2023 and April 2025. Data on demographics, comorbidities, clinical parameters, and risk factors were collected using a structured questionnaire. Follow-up assessments were performed at 7 days, 1 month, 3 months, 6 months, and 1 year to evaluate clinical status and outcomes, including recovery, recurrence, and mortality. Descriptive statistics were applied using SPSS (version 22). Results: Of the 60 participants, 36 (60%) were male and 24 (40%) were female, with a mean age of 53.97 ± 16.17 years. Diabetes mellitus (56.7%) and hypertension (16.7%) were the most frequent comorbidities, while recent surgery (25%) and prolonged immobilization (16.7%) were significant risk factors. At one-year follow-up, 20 patients (33%) had died due to PE, 12 (20%) died from other causes, 16 (27%) showed clinical improvement, 2 (3.3%) experienced recurrent PE, and 1 (1.7%) developed chronic thromboembolic pulmonary hypertension (CTEPH). Rivaroxaban was the most common anticoagulant used (66.7%). Conclusion: PE patients in Swat demonstrated a high mortality rate, particularly during the first three months after diagnosis. Diabetes, hypertension, recent surgery, and prolonged immobilization were identified as key risk factors. Strengthening follow-up care and implementing structured long-term management protocols are essential to reduce PE-related complications.