ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Clinical features of pulmonary infarction in elderly patients with pulmonary embolism: a retrospective comparative study
Provisionally accepted
- Beijing Luhe Hospital, Capital Medical University, Beijing, China
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Objective: To analyze the clinical characteristics of pulmonary infarction in elderly patients with pulmonary embolism. Methods: We conducted a single-center retrospective study of 71 patients with pulmonary infarction (PI) secondary to pulmonary embolism (PE) confirmed by CTPA between January 2016 and December 2021. Participants were stratified into elderly (≥65 years) and non-elderly (<65 years) groups. We compared baseline characteristics, laboratory/imaging findings, Wells scores, PE severity, diagnosis and treatment using chi-square and Mann-Whitney U tests. Results: PI occurred in 17.1% (71/414) of PE cases, comprising 36 elderly patients and 35 non-elderly patients. Significant differences were observed in pleuritic chest pain, hemoptysis, cardiovascular disease, cerebrovascular disease, pulmonary hypertension, and ECG changes between the two groups (P<0.05). PI occurred predominantly in the right lung and in lower lobes. No significant differences were observed in infarction location, number, or imaging signs between groups. The comparison of PE risk factors and Wells scores showed no significant differences. The elderly group showed a higher proportion of intermediate-high risk and a lower proportion of low-risk in PE severity classification (P<0.05). During the medical consultation process, elderly exhibited higher non-emergency/respiratory first-visit rates than younger (P<0.05). Similarly high rates of antibiotic therapy were observed in both groups (P>0.05). Conclusion: Elderly PI patients have less typical chest pain, hemoptysis or ECG changes, a high proportion of comorbid cardiovascular/cerebrovascular diseases, and a higher rate of mismatch in the first visiting department. Clinicians should recognize the atypical presentations of PI in elderly patients and pay increased attention to this population.
Keywords: Pulmonary Infarction, pulmonary thromboembolism, embolus, Elderly, Clinical Characteristics
Received: 21 Aug 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Xing, Yuan, Zhang, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shuai Zhang, zhangshuai1974@ccmu.edu.cn
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