Acute pulmonary thromboembolism: Epidemiology, predictors, and long-term outcome – A single center experience

Nagamalesh, U.M.; Prakash, Varsha; Naidu, K.C. Karthik; Sarthak, Siddhant; Hegde, Anupama; Abhinay, T

doi:10.1016/j.ihj.2016.08.010

Cited by 28 publications

(18 citation statements)

References 24 publications

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“…Given the significant mortality associated with PEs, a number of studies have retrospectively assessed various risk factors including advanced age, prolonged immobility, malignancy, polytrauma, recent major surgery, heart failure, prior venous thromboembolism, and dyslipidemia that can be utilized as diagnostic indicators [4]. As for clinical risk stratification tools, the pulmonary embolism severity index (PESI) and its simplified version, sPESI, include assessment of age, sex, health history, vitals, and presence of alteration in mental status as factors to estimate 30-day mortality risk.…”

Section: Discussionmentioning

confidence: 99%

Submassive Pulmonary Embolism: A Re-evaluation of Hemodynamic Instability

Obi

Packer

2019

Cureus

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Current medical management of pulmonary embolism (PE) is driven by risk stratification, with thrombolytic treatment reserved for patients with hemodynamic instability. We describe a case of a man with acute submassive bilateral pulmonary emboli and a right popliteal deep vein thrombosis (DVT), who had persistent shortness of breath, tachycardia, and hypoxemia but remained normotensive and was therefore not treated with thrombolytics until he suffered a fatal cardiac arrest on hospital day six. We examine the indications, risks, and potential benefits of thrombolytic treatment in patients with submassive PE who exhibit signs of instability but do not meet current indications for thrombolytic treatment with persistent hypotension or shock.

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Section: Discussionmentioning

confidence: 99%

Submassive Pulmonary Embolism: A Re-evaluation of Hemodynamic Instability

Obi

Packer

2019

Cureus

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“…Acute pulmonary embolism (PE) is basically a detrimental form of venous thromboembolism (VTE) with an approximate 90-day fatality rate of 15-20%. 1,2 It occurs in about one-third of patients with VTE 3 and remains a cause of cardiovascular death. 4 Therefore, appropriate risk-stratification based on primary predisposing factors is crucial for the discrimination and aggressive management of high-risk individuals.…”

Section: Introductionmentioning

confidence: 99%

<p>Prevalence and Outcomes of Thrombophilia in Patients with Acute Pulmonary Embolism</p>

Obaid

El‐Menyar

Asim

et al. 2020

VHRM

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Background: We aimed to study the prevalence and outcomes of thrombophilia in acute pulmonary embolism. Methods: A retrospective observational study was conducted to include patients with a radiologically confirmed diagnosis of PE screened for thrombophilia from May 2011 to February 2015. Data included patients' demographics; clinical presentation, risk factors, laboratory investigations, management, and outcome were analyzed and compared in patients with and without thrombophilia. Results: A total of 227 cases of PE were included in the study, of which 108 (47.6%) had thrombophilia. The most frequent coagulopathic abnormality included deficiency of protein S, protein C, and antithrombin III and hyperhomocysteinemia. Only seven out of 79 patients were found to have factor V Leiden. PE patients diagnosed with thrombophilia were 10 years younger in age and peaked in the age range 30-39 years. Prior history of DVT (p=0.001) and PE (p=0.001) were the main significant risk factors in the thrombophilia group. The frequency of different risk categories of clinical probability scores did not differ significantly among those with and without thrombophilia. Pulmonary hypertension was a common complication in the thrombophilia group (P=0.009). Medications used included warfarin (74.7%), enoxaparin (73.9%), and heparin (55.4%). The overall mortality rate was 8.4%, and was non-significantly higher in the non-thrombophilia group. Conclusion: Deficiencies of protein S, protein C, and antithrombin III are the leading causes of thrombophilic defects. Patients with hereditary thrombophilia are at increased risk of acute PE, particularly among young individuals. Therefore, early detection of thrombophilic defects together with other unprovoked risk factors could reduce the risk of recurrent VTE.

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“…Patients with unrecognized acute PE have an estimated mortality rate of 30% [2]. However, the death rate can be reduced to 2-10% if PE is diagnosed at the right time [3].…”

Section: Introductionmentioning

confidence: 99%

The Association between the Pulmonary Arterial Obstruction Index and Atrial Size in Patients with Acute Pulmonary Embolism

Langroudi

Sheikh

Naderian

et al. 2019

Radiology Research and Practice

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Purpose. Pulmonary embolism (PE) is a common and potentially fatal form of venous thromboembolism. The aim of this study is to investigate the association between the pulmonary arterial obstruction index and atrial size in patients with acute pulmonary embolism. Basic Procedure. The study consisted of 86 patients with clinical symptoms of PE. Out of 86 individuals, 50 patients were diagnosed with PE and considered as the patient group. The others were considered as the control group. All patients were scanned by a multidetector CT scanner. Using the radiology workstation, an expert radiologist calculated the left atrium (LA) and right atrium (RA) areas from planimetric measurements obtained from free-hand delineation of the atrial boarders using an electronic pen. Quantitative volumetric measurements of LA and RA were obtained from original axial images. Main Findings. There were 25 males and 25 females with PE, who had a mean age of 58 years. There was not a significant difference in the positive history of diabetes mellitus, hypertension, asthma, chronic obstructive pulmonary diseases, ischemic heart disease, and smoking between patients and control group. There was a significant negative correlation between almost all LA measurements and the PAOI. RA area and volume had the highest area under the curves for recognizing larger clot burden. Principal Conclusions. A higher clot load is associated with a smaller LA size and increased RA/LA ratios, measured with CTPA. Atrial measurements are correlated with POAI, and they could be used as sensitive parameters in predicting heart failure in patients with PE.

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Acute pulmonary thromboembolism: Epidemiology, predictors, and long-term outcome – A single center experience

Cited by 28 publications

References 24 publications

Submassive Pulmonary Embolism: A Re-evaluation of Hemodynamic Instability

Submassive Pulmonary Embolism: A Re-evaluation of Hemodynamic Instability

<p>Prevalence and Outcomes of Thrombophilia in Patients with Acute Pulmonary Embolism</p>

The Association between the Pulmonary Arterial Obstruction Index and Atrial Size in Patients with Acute Pulmonary Embolism

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