Epidemiological features of Pulmonary Embolism

Talbot, Steven R.

doi:10.1111/j.1742-1241.1972.tb04437.x

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Há autores que consideram uma prevalência de 20-30% em homens, independentemente da cor; outros relatam maior prevalência em mulheres e há quem não observe diferenças significativas entre os números. [13][14][15] Em estudos com autópsias realizados em Tóquio e Istambul, a prevalência de TEP foi mais elevada nas mulheres, enquanto que em Nova Iorque e em Belo Horizonte a predominância foi nos homens. No entanto, a razão da discrepância entre a prevalência seja em homens ou mulheres não é clara, visto que, o sexo feminino detém maior exposição aos fatores de risco para o desenvolvimento de TEP.…”

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Perfil Epidemiológico do Tromboembolismo Pulmonar no Brasil de 2015 a 2019

Pinheiro da Silva,

Barros Souza,

Costa de Oliveira

et al. 2021

Bepa

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O Tromboembolismo Pulmonar (TEP) é uma doença cardiovascular aguda que acomete cerca de 1 a cada 1000 pessoas por ano nos Estados Unidos, sendo a terceira causa de morte mais comum no ambiente hospitalar. Com isso, o objetivo deste estudo foi descrever o perfil epidemiológico de casos de TEP no Brasil no período de janeiro de 2015 a dezembro de 2019. A partir do Sistema de Informações Hospitalares do Sistema Único de Saúde brasileiro (SIH/SUS) foram obtidos dados sobre todos os casos de TEP notificadosno Brasil de 2015 a 2019. Nesse período, o número de internações por TEP no Brasil foi de 42.411, concentrando-se na região sudeste (54,7%), entretanto, a região com a maior taxa de letalidade hospitalar (25,38%) foi o Nordeste. Quanto ao sexo, observa-se a prevalência de internações e óbitos nas mulheres, contudo, em comparação, a taxa de letalidade hospitalar dos homens é superior em 1.77%. Em relação a raça, constata-se que a branca é a mais acometida, sobretudo nas mulheres. É notória a correlação entreos fatores sociodemográficos e o desenvolvimento do TEP, visto que as regiões com menor Índice de Desenvolvimento Humano (IDH) do Brasil (norte e nordeste) lideram o ranking no que se refere à letalidade hospitalar. Por isso, é necessária a implementação de ferramentas que estimulem a prevenção do TEP e seus fatores de risco, visando diminuir a taxa de letalidade e incidência de casos no Brasil.

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Section: Discussionunclassified

Perfil Epidemiológico do Tromboembolismo Pulmonar no Brasil de 2015 a 2019

Pinheiro da Silva,

Barros Souza,

Costa de Oliveira

et al. 2021

Bepa

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Patients with isolated pulmonary embolism in comparison to those with deep venous thrombosis. Differences in characteristics and clinical evolution

Palareti¹,

Antonucci²,

Dentali

et al. 2019

European Journal of Internal Medicine

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Background: Patients with acute pulmonary embolism (PE) often have leg deep vein thrombosis (DVT); sometimes, however, a DVT is not detected (isolated PE, I-PE). We aimed at assessing the proportion of patients with I-PE, and their characteristics and clinical evolution compared to those with DVT with/without PE (DVT/PE). Methods: Among 3573 patients included in the START2-Register for a venous thromboembolic event, 2880 (80.6%) had DVT/PE, the remaining I-PE (19.4%). Results: Patients with I-PE were older [(≥75 years, OR 1.4 (95%CI 1.13-1.69)], and more frequently females ]. Young females (aged ≤ 50 years) with an index event occurring during hormonal contraception (HC), were more prevalent in I-PE ]. At multivariate analysis, age > 75 years, female sex, heart failure, cancer and use of HC were risk factors significantly associated with I-PE, whereas thrombophilic alterations were associated with DVT/PE. During a follow-up of 4504 years (during anticoagulation), the rate of bleeding events was 1.1% patient/years and 1.0% patient/years in I-PE and DVT/PE, respectively. Venous thromboembolic events were equally prevalent in DVT/PE or I-PE (1.94% vs 0.86%, ns), whereas arterial complications were more prevalent in the latter group (1.01% vs 0.28%, p = 0.008). Conclusion: I-PE and DVT/PE have important differences. Older age, female sex, heart failure and cancer, were risk factors for I-PE; thrombophilic alterations were associated with DVT/PE. HC use was more frequent in the I-PE group. The prevalence of arterial complications was higher in patients with I-PE. Further studies, specifically designed on this issue, are warranted.Survival after 3 months from the event has been reported as low as 62.8% in case of PE, a rate much lower than that after DVT alone (91.9%) [5]. The 30-day case-fatality rate is higher in patients with PE than in those with DVT (9.7% vs. 4.6%, respectively [4]), with a risk of dying that is higher in the first months from the event, to gradually lower subsequently.In the majority of cases, PE occurs as a complication of a clinically

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Duration of anticoagulation after isolated pulmonary embolism

Palareti

Cosmi

Antonucci³

et al. 2016

Eur Respir J

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In the D-dimer and ULtrasonography in Combination Italian Study (DULCIS), serial D-dimer measurement in combination with assessment of residual thrombosis (in patients with deep vein thrombosis (DVT)) identified patients who safely discontinued anticoagulation after an unprovoked venous thromboembolism (VTE).In this subgroup analysis, the value of D-dimer tests was assessed in patients with isolated pulmonary embolism (PE) compared with those with DVT, with or without PE (DVT/PE). The DULCIS database was reanalysed in relation to this target.26.8% of the DULCIS patients had isolated PE as the index event; this was more prevalent in females (34.1%) than in males (21.1%; p<0.0001). The rate of positive D-dimer was similar in isolated PE and DVT/PE. The rate of recurrences was not different in isolated PE or DVT/PE patients (4.8% ppy versus 3.8% ppy; nonsignificant) who stopped anticoagulation for negative D-dimer, but it was markedly high (11.2% ppy; p<0.0001) in those with isolated PE who remained without anticoagulation despite positive D-dimer. Recurrences were more frequently new isolated PE in patients with isolated PE than with DVT/PE (six (46.2%) out of 13 versus two (7.4%) out of 27; p=0.0085).Serial D-dimer assessment can inform on the risk of recurrent VTE and help determine the duration of anticoagulation in patients with isolated PE.

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Epidemiological features of Pulmonary Embolism

Cited by 4 publications

References 17 publications

Perfil Epidemiológico do Tromboembolismo Pulmonar no Brasil de 2015 a 2019

Perfil Epidemiológico do Tromboembolismo Pulmonar no Brasil de 2015 a 2019

Patients with isolated pulmonary embolism in comparison to those with deep venous thrombosis. Differences in characteristics and clinical evolution

Duration of anticoagulation after isolated pulmonary embolism

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