The risk factors for all-cause in-hospital death in patients with acute pulmonary embolism

Introduction: Patient risk stratification is important in managing individuals with suspected acute pulmonary embolism (APE). The aim of this study was to determine risk factors for in-hospital mortality among real-world patients who had undergone computed tomography pulmonary angiography (CTPA) due to suspected APE.Material and methods: Retrospective analysis of clinical data extracted from the medical documentation of 700 consecutive patients in whom CTPA was performed due to APE suspicion.Results: APE was confirmed in 22.7% of the patients in the sample. In-hospital death was recorded in 10.1% and 12.4% of patients with and without APE confirmed in CTPA, respectively. APE-related death was diagnosed in 37.5% of the APE patients who died during hospitalization. Compared to patients who were discharged from hospital, those who died during hospitalization had a greater prevalence of comorbidities (e.g., neoplasm) and higher values of laboratory determinations and prognostic rule scores. An age-adjusted high-sensitivity troponin I (hs-TNI) cut-off and Pulmonary Embolism Severity Index (PESI) score were found to be independent risk factors of in-hospital death, but only in the whole study group and in patients without APE confirmed in CTPA. The area-under-the-curve value for all the parameters studied was lower than 0.6.Conclusions: Age-adjusted hs-TNI cut-off and PESI score were independent risk factors for in-hospital death in patients with APE suspicion. The predictive power of standard stratifying tools is insufficient in real-world patients with suspected APE. Patients with suspected APE require careful diagnosis and management of comorbidities because these may affect the in-hospital mortality rate

State regulation in foreign economic activity of cement industry of Ukraine

To specify the problems and priorities of state regulation of foreign economic activity (FEA) of cement industry enterprises of Ukraine, it is proposed to use the tool for assessing the state of FEA of cement industry enterprises, which is based on the expert method. The FEA development index of the cement industry is constructed with the usage of the method of expert assessments and analysis of the hierarchies of significance of each factor. Due to this, it was found that producers underestimate their own abilities to compete in foreign markets regarding the assortment structure, unsatisfactory financial condition, fierce competition and recession in foreign markets, especially traditional for Ukraine; unsatisfactory state policy of support of the development of the cement industry, in particular in terms of transparency of resource provision, assistance in updating the technical and technological base of the industry, the implementation of state infrastructure projects in Ukraine. On this basis, the priorities of state regulation of foreign economic activity of cement industry enterprises were determined by the following groups: sales, institutional and instrumental ones