〔Abstract〕 Objective To investigate the risk factors of short-term adverse prognosis and the predictive value of Charlson comorbidities index(CCI) in patients with central pulmonary embolism(PE). Methods 115 cases of central PE patients were retrospectively analyzed. According to the adverse prognosis during hospitalization, the subjects were divided into adverse event group and no adverse event group. The clinical characteristics of the adverse event group were analyzed. Multivariate Logistic regression analysis was performed for statistically significant indicators. Results The most common clinical symptoms of central PE patients were chest distress or dyspnea(77.4%), followed by cough(35.7%), chest pain(28.7%), syncope(9.6%) and hemoptysis(7.8%). There were no statistically significant differences in gender, smoking history, drinking history, symptoms and signs between the two groups. In univariate analysis, CCI, grouping score of thrombus location, white blood cell count, neutrophil count and urea nitrogen were associated with adverse events in central PE patients, with statistical significance(P<0.05). After Logistic regression multivariate analysis, increased neutrophil count(OR=1.494, 95%CI: 1.073-2.080,P=0.017) was an independent risk factor(P<0.05). The CCI in the group with adverse events was higher than that in the group without adverse events(P=0.004). Multivariate analysis showed that increased CCI(OR=1.342, 95%CI: 1.022-1.763,P=0.034) was an independent risk factor, and the risk of adverse events increased by 34.2% for every one-point increase in CCI. The thrombus location score of the group with adverse events was significantly higher than that of the group without adverse events(OR=2.586, 95%CI: 1.366-4.896,P=0.004), and the risk of adverse events increased 1.586 times with each increase of thrombus location score. Conclusion Increased neutrophil count, CCI, and thrombus location score are associated with poor short-term prognosis in central PE patients.