Features of in-hospital clinical course of pulmonary embolism in patients of different age groups

Aim. To study the blood coagulation status by various laboratory methods in patients after pulmonary embolism (PE) receiving long-term anticoagulant therapy.Material and methods. The blood of 23 patients with pulmonary embolism, who received long-term anticoagulant therapy, was studied. The study of coagulation profile, D-dimer, thrombodynamics, thromboelastography and thrombin generation test were carried out.Results. The thrombin generation test shows a significant increase in the time of its formation, while the maximum amount of thrombin formed is half that of the reference values. There is a slightly increased median fibrin clot growth rate in the thrombodynamics test — 30,4 gm/min with a normal coagulation rate of 20-29 gm/min. The result of thromboelastography also reflects the blood hypocoagulation, in terms of R, Angle a and CI.Conclusion. Integral methods for assessing the thrombotic readiness in combination with a routine coagulation panel demonstrate a complete picture of blood coagulation potential in patients after pulmonary embolism requiring long-term anticoagulant therapy.

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Coagulation status in patients with pulmonary embolism receiving long-term anticoagulant therapy

Шмидт

Бернс

Penskaya

et al. 2022

Cardiovasc Ther Prev

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Factors associated with the development of a lethal hospital outcome in patients with pulmonary embolism in different age groups

et al. 2023

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Background. The study of the tactics of managing patients with pulmonary embolism in the hospital period allows to find new approaches to treatment to reduce mortality. At the same time, it is known that the risk factors for death in patients of different age categories differ. Aim. To study the features of the course of the disease and risk factors for a fatal hospital outcome in patients with pulmonary embolism in different age groups of participants in the All-Russian registry, which was named SIRENA (RusSIan REgister of pulmoNAry embolism). Material and methods. The study included 570 patients with pulmonary embolism (database of the SIRENA multicenter registry in 20182019), who underwent a standard examination. They were divided into two groups according to age: the first group was 1869 years old inclusive (n=369), the second group was 70 years and older (n=201). Differences in clinical history, laboratory and instrumental parameters in the studied groups of patients were assessed. Statistical comparison of data was performed using the MannWhitney test, Pearson test, and Fisher's exact test. For a quantitative description of the closeness of the association of a sign with the outcome of the disease, the odds ratio with a 95% confidence interval was determined. Results. In the group of patients aged 1869 years, deaths occurred 3 times less frequently than in the group of patients aged 70 years and older (8.9 vs 26.3%; p 0.0001). The risk of death increases in the presence of atrial fibrillation by 2.6 times (p=0.032), anemia with hemoglobin 113 g/l by 4.3 times (p=0.0002), chronic kidney disease by 5.5 times (p=0.001), increase in blood creatinine 125 mmol/l 5.8 times (p 0.001). Additional risk factors in patients aged 70 years and older are ischemic heart disease (p=0.02), a history of stroke (p=0.003), and immobilization for 12 months prior to hospitalization (p 0.0001). Conclusion. In patients aged 1869 years, atrial fibrillation, anemia, and impaired renal function are fatal risk factors; at the age of 70 years and older, along with these, previous immobilization and comorbid cardiovascular pathology have an adverse effect.

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Clinical and functional status and postoperative complications in patients with chronic thromboembolic pulmonary hypertension in the age aspect

Kamenskaya,

Klinkova,

Loginova

et al. 2024

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Aim. To study the clinical and functional status and the early postoperative follow-up in elderly patients with chronic thromboembolic pulmonary hypertension (CTEPH).Material and methods. Patients with CTEPH were divided into two groups: group 1 (35 people) – patients ≥65 years old, group 2 (98 people) – <65 years old. The baseline clinical and functional data of both groups and the in-hospital period after pulmonary endarterectomy, were analysed.Results. Patients with CTEPH ≥65 years old compared with patients <65 years old were characterized by a higher comorbidity, a higher incidence of adverse cardiovascular events and the presence of chronic heart failure IV class (p<0.05). Echo-CG data in patients with CTEPH ≥65 years old were characterized by a large size of the left atrium, more pronounced hypertrophy of the right ventricle free wall, interventricular septum and the left ventricular posterior wall compared with younger patients (p<0.05). Also, in patients ≥65 years old, lower values of the left ventricular ejection fraction were found with preservation of global myocardial contractility (p<0.05). The early postoperative period in patients with CTEPH ≥65 years is characterized by a more severe course compared to the group of patients <65 years due to a larger proportion of patients with the development of newly diagnosed atrial fibrillation, multiple organ failure and postoperative bleeding (p<0.05). Despite this, there were no intergroup differences in the length of the hospital period and in-hospital mortality (p>0.05).Conclusion. The early postoperative results of pulmonary endarterectomy in elderly patients with CTEPH showed no differences in the length of hospital stay and in-hospital mortality compared with younger patients, which indicates the feasibility of surgical treatment of this category of patients in the specialized cardiac surgical centers.

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Features of in-hospital clinical course of pulmonary embolism in patients of different age groups

Cited by 3 publications

References 16 publications

Coagulation status in patients with pulmonary embolism receiving long-term anticoagulant therapy

Coagulation status in patients with pulmonary embolism receiving long-term anticoagulant therapy

Factors associated with the development of a lethal hospital outcome in patients with pulmonary embolism in different age groups

Clinical and functional status and postoperative complications in patients with chronic thromboembolic pulmonary hypertension in the age aspect

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