Evidence-based perioperative diagnosis and management of pulmonary embolism: A systematic review

Abate, Lamesgen Geta; Bayable, Samuel Debas; Fetene, Melaku Bantie

doi:10.1016/j.amsu.2022.103684

Cited by 3 publications

(4 citation statements)

References 33 publications

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“…In the recurrent group, there was a possibility that these patients may have been under medication for a longer period because of the severity of VTE in reducing psychiatric symptoms before and after the VTE-related procedure, and may have caused events such as oversedation and immobilization of the patient, which may have been associated with an increased risk of VTE recurrence. [ 33 , 34 ]. Therefore, patients with a history of VTE should be carefully monitored during long-term use because sedation or immobility due to drug treatment for psychiatric diseases, including APs, has been reported to be related to the onset of VTE.…”

Section: Discussionmentioning

confidence: 99%

Association of Antipsychotic Drugs with the Risk of Recurrent Venous Thromboembolism: A Retrospective Study of Data from a Japanese Inpatient Database

Hashimoto,

Imai,

Yamashita

et al. 2023

Drugs - Real World Outcomes

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Background Approximately a decade has passed since the addition of venous thromboembolism to the list of significant adverse reactions of antipsychotic drugs. However, only a few studies have investigated the relationship between antipsychotic use and venous thromboembolism in the Japanese population. Purpose We aimed to evaluate the risk of recurrent venous thromboembolism in users of antipsychotic drugs and update the evidence on venous thromboembolism in the Japanese population. Methods A cross-sectional retrospective analysis of data from a large Japanese claims database, managed by Medical Data Vision Co. Ltd., was conducted. Adult patients who experienced venous thromboembolism between October 2014 and September 2018 in acute care hospitals were identified. The risk of recurrent venous thromboembolism was evaluated with logistic regression using demographic variables. The data of patients using antipsychotic drugs within specific therapeutic classes were also evaluated. Results We included 8960 patients (mean age, 69 years; 59.2% female). Recurrent venous thromboembolism was observed in 686 patients (7.7%). The risk of recurrent venous thromboembolism was significantly higher in younger patients [< 65 years: reference; 65–74 years: odds ratio (OR) 0.81, 95% confidence interval (CI) 0.66–0.99, p = 0.04; ≥ 75 years: OR 0.77, 95% CI 0.64–0.94, p = 0.01], those with history of surgery (OR 1.39, 95% CI 1.18–1.65, p = 0.01), and anticoagulant users (OR 2.25, 95% CI 1.46–3.48, p = 0.01) and was significantly lower in the presence of comorbidities (OR 0.68, 95% CI 0.58–0.81, p < 0.01) and fractures (OR 0.49, 95% CI 0.26–0.94, p = 0.03). Long-term antipsychotic drug prescriptions (> 14 days) were associated with a higher risk of venous thromboembolism than short-term prescriptions (≤ 14 days) (OR 1.56, 95% CI 1.04–2.34, p = 0.03). Conclusions In patients with a history of venous thromboembolism, particular attention should be paid to recurrence in younger patients. If antipsychotic drugs are prescribed for > 14 days to patients with a history of venous thromboembolism, they should be administered carefully, guided by reported findings. Further evaluations using different databases or populations are required to generalize the findings of this study. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-023-00401-2.

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Section: Discussionmentioning

confidence: 99%

Association of Antipsychotic Drugs with the Risk of Recurrent Venous Thromboembolism: A Retrospective Study of Data from a Japanese Inpatient Database

Hashimoto,

Imai,

Yamashita

et al. 2023

Drugs - Real World Outcomes

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“…Right lower base crepitations were detected upon lung auscultation. The Wells score indicated a moderate risk [3], alongside with a D-dimer level of 2210 ng/m. This prompted a CTPA investigation due to ongoing symptoms, heightening suspicion for an undiagnosed PE.…”

Section: Copy Right © Hasan Hazim Alsararateementioning

confidence: 99%

Atypical Presentation of Pneumonia Mimicking Pulmonary Embolism

Alsararatee

2024

IJMCRMR

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This case report highlights the diagnostic challenge arises from the varied clinical presentation, complicating the differentiation between infarction pneumonia, community-acquired pneumonia (CAP), and pulmonary embolism (PE). The author reports a female patient in her late seventies who presents with worsening right-sided pleuritic chest pain, exertional dyspnoea, and productive cough. She was initially treated for CAP with oral amoxicillin 500 mg QDS and clarithromycin 500 mg twice daily for 5 days. She denied any night sweats or weight loss. On lung auscultation, she had right lower lobe crepitations. Subsequently, she underwent a computed tomography pulmonary angiography (CTPA) to rule out PE which demonstrated filling defects in the right pulmonary artery and right lower lobe patchy consolidation. The patient was treated with rivaroxaban 15 mg BD for 21 days followed by 20 mg OD for 4 months, and also treated for CAP with ceftriaxone 2 g OD for 7 days.

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Section: Introductionmentioning

confidence: 99%

“…In the surgical patient, however, standard approaches become intricate challenges in the management of PE [1]. Contrasting trends in increased PaCO 2 and decreased ETCO 2 levels can serve as early indicators of potential PE in patients undergoing general anesthesia and mechanical ventilation [2]. Differential diagnosis of sudden cardiovascular collapse under general anesthesia includes allergic reactions, hemorrhage, hypovolemia, or pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Catastrophic Acute Pulmonary Embolism: A Case Report

Gier,

Diz Ferre,

Ayad

2024

Cureus

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This case report describes a 75-year-old female with a medical history including recurrent bowel obstruction due to sigmoid stricture, atrial fibrillation managed with rivaroxaban, a 50-year one pack-per-day smoking history, hypertension, hyperlipidemia, peripheral vascular disease with bilateral iliac stents (2015), stage III chronic kidney disease, and renal artery stenosis with bilateral stenting. She was transferred from outside hospital for an elective sigmoidectomy with ileorectal anastomosis following several recent admissions due to bowel obstruction that had been managed non-operatively. She was deemed optimized for surgery by the primary care team; however, during induction, she developed pulseless ventricular tachycardia requiring extensive resuscitative efforts. Intraoperative findings revealed biventricular failure and a clot in the right pulmonary artery. Despite aggressive treatment, including veno-arterial extracorporeal membrane oxygenation (VA ECMO), the patient's condition deteriorated, and life support was ultimately withdrawn. This case highlights the challenges of managing complex surgical patients and underscores the importance of multidisciplinary care in such cases.

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Evidence-based perioperative diagnosis and management of pulmonary embolism: A systematic review

Cited by 3 publications

References 33 publications

Association of Antipsychotic Drugs with the Risk of Recurrent Venous Thromboembolism: A Retrospective Study of Data from a Japanese Inpatient Database

Association of Antipsychotic Drugs with the Risk of Recurrent Venous Thromboembolism: A Retrospective Study of Data from a Japanese Inpatient Database

Atypical Presentation of Pneumonia Mimicking Pulmonary Embolism

Intraoperative Catastrophic Acute Pulmonary Embolism: A Case Report

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