Pulmonary Embolism in Young and Elderly Patients: Clinical Characteristics, Laboratory and Instrumental Findings and Differences Between Age Groups

Şen, Nazan; Ermiş, Hilal; Altınkaya, Naime; Ermis, Necip; Karatasli, Meltem; Ulubay, Gaye

doi:10.5152/ttd.2010.26

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Pulmonary thromboembolism is a disease whose incidence, prevalence, morbidity and mortality increase with age. 4 For this reason, it is not considered in most young age patients, and the diagnosis of medium and high risk PTE in the young population becomes difficult.…”

Section: Discussionmentioning

confidence: 99%

One year follow-up and literature review of three young-age cases with high risk pulmonary thromboembolism

Altan Çotur,

Kurt,

Demirkaya

2024

ICJIM

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High-risk pulmonary thromboembolism (PTE) is an emergency clinical condition with high mortality. High-risk pulmonary thromboembolism is generally seen in immobile patients, elderly, have malignancies, and have a long-term travel history. Our aim here is to emphasize that high-risk pulmonary thromboembolism may also occur in young patients. Considering the symptoms and risk factors such as oral contraceptive use, obesity, and operation history, PTE can be detected with Pulmonary Computed Tomography-Angiography (CTPA) or Ventilation Perfusion Scintigraphy (V/Q) when necessary. It should be verified that it is not. Genetic mutation, obesity, oral contraceptive use, and previous operation history were accepted as risk factors in the young patients we treated and followed up with high-risk Pulmonary Thromboembolism presented here. After the diagnosis of pulmonary thromboembolism was made at the first stage in our patients who applied to the emergency department, the risk group was determined by taking into account the current guidelines. Three patients considered to be at high risk were evaluated for thrombolytic therapy. Two patients without contraindications were given a full dose, and one patient was given a half dose of thrombolytic. After being monitored in intensive care for the first 24 hours, they were taken to the service. Due to their young age (<45 years), their thrombophilia panel was checked. Anticoagulant treatments were started and follow-ups were planned at 3 months, 6 months, and 1 year after discharge. During the follow-up visits, CTPA, echocardiography (ECHO), and lower extremity Doppler ultrasound imaging were performed.

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Section: Discussionmentioning

confidence: 99%

One year follow-up and literature review of three young-age cases with high risk pulmonary thromboembolism

Altan Çotur,

Kurt,

Demirkaya

2024

ICJIM

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“…suggesting that there is no correlation. 7,8 Gamma-glutamyl transferase (GGT) is a membrane protein that functions in the extracellular catabolism of glutathione.…”

Section: Introductionmentioning

confidence: 99%

Elevated gamma glutamyl transferase levels are associated with the location of acute pulmonary embolism. Cross-sectional evaluation in hospital setting

et al. 2015

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Elevated gamma glutamyl transferase levels are associated with the location of acute pulmonary embolism. Cross-sectional evaluation in hospital setting ABSTRACTCONTEXT AND OBJECTIVE: The location of embolism is associated with clinical findings and disease severity in cases of acute pulmonary embolism. The level of gamma-glutamyl transferase increases under oxidative stress-related conditions. In this study, we investigated whether gamma-glutamyl transferase levels could predict the location of pulmonary embolism. DESIGN AND SETTING: Hospital-based cross-sectional study at Cumhuriyet University, Sivas, Turkey. METHODS: 120 patients who were diagnosed with acute pulmonary embolism through computed tomography-assisted pulmonary angiography were evaluated. They were divided into two main groups (proximally and distally located), and subsequently into subgroups according to thrombus localization as follows: first group (thrombus in main pulmonary artery; n = 9); second group (thrombus in main pulmonary artery branches; n = 71); third group (thrombus in pulmonary artery segmental branches; n = 34); and fourth group (thrombus in pulmonary artery subsegmental branches; n = 8).RESULTS: Gamma-glutamyl transferase levels on admission, heart rate, oxygen saturation, right ventricular dilatation/hypokinesia, pulmonary artery systolic pressure and cardiopulmonary resuscitation requirement showed prognostic significance in univariate analysis. The multivariate logistic regression model showed that gamma-glutamyl transferase level on admission (odds ratio, OR = 1.044; 95% confidence interval, CI: 1.011-1.079; P = 0.009) and pulmonary artery systolic pressure (OR = 1.063; 95% CI: 1.005-1.124; P = 0.033) remained independently associated with proximally localized thrombus in pulmonary artery. CONCLUSIONS:The findings revealed a significant association between increased existing embolism load in the pulmonary artery and increased serum gamma-glutamyl transferase levels. RESUMO CONTEXTO E OBJETIVO:A localização da embolia está associada com os resultados clínicos e a gravidade da doença do embolismo pulmonar agudo (EPA). O nível de gama-glutamil transferase (GGT) aumenta em condições relacionadas com estresse oxidativo. Investigou-se se os níveis de GGT podem prever a localização do EPA. TIPO DE ESTUDO E LOCAL: Estudo observacional transversal na Universidade Cumhuriyet, Sivas, Turquia. MÉTODOS: Avaliamos 120 pacientes diagnosticados com EPA após a realização de angiografia pulmonar assistida por tomografia computadorizada. Eles foram divididos em dois grupos principais (localização proximal e distal) e depois em subgrupos de acordo com a localização do trombo da seguinte forma: primeiro grupo (trombo na artéria pulmonar [AP] principal, n = 9); segundo (trombo no ramo da AP principal; n = 71); terceiro grupo (trombo na segmentar da AP; n = 34); quarto grupo (trombo na subsegmentar da AP; n = 8). RESULTADOS: Na análise univariada, os níveis de GGT tiveram significado prognóstico em relação à admissão, pulsação arterial, saturação ...

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Assessments of the associations of thrombus localization with accompanying disorders, risk factors, D-dimer levels, and the red cell distribution width in pulmonary embolism

Sünnetçioğlu¹,

Sertoğullarından²,

Özbay³

et al. 2015

Clinics

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OBJECTIVE:Pulmonary embolisms occur as a wide spectrum ranging from clinically asymptomatic thrombi to massive thrombi that lead to cardiogenic shock. The purpose of this study was to determine the associations of thrombus localization with risk factors, accompanying disorders, D-dimer levels and the red blood cell distribution width in patients with pulmonary embolism.MATERIAL AND METHODS:In 148 patients diagnosed with pulmonary embolism, the presence and anatomical localization of the thrombus were assessed via computed tomographic pulmonary angiography. The accompanying disorders, risk factors, serum D-dimer levels, and red blood cell distribution width of the patients were retrospectively evaluated. ClinicalTrials.gov: NCT02388841.RESULTS:The mean age of the patients was 54±16.0 years, and 48 patients were ≥65 years of age. The most frequent accompanying disorders were chronic obstructive pulmonary disease (22%) and malignancy (10.1%), and the most frequent risk factors were recent operation (14.1%) and immobilization (18.2%). Thrombi were most frequently observed in the right pulmonary artery (37.8%). In 31% of the patients, the thrombus was localized to the main pulmonary arteries. Immobile patients exhibited a higher proportion of thrombi in the main pulmonary arteries than mobile patients. The mean D-dimer level and the mean red blood cell distribution width in the patients with thrombi in the main pulmonary arteries were higher than those in the patients with thrombi in more distal pulmonary arterial branches.CONCLUSION:Significant associations of proximally localized thrombi with immobilization, the D-dimer levels, and the red blood cell distribution width were observed.

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Pulmonary Embolism in Young and Elderly Patients: Clinical Characteristics, Laboratory and Instrumental Findings and Differences Between Age Groups

Cited by 3 publications

References 25 publications

One year follow-up and literature review of three young-age cases with high risk pulmonary thromboembolism

One year follow-up and literature review of three young-age cases with high risk pulmonary thromboembolism

Elevated gamma glutamyl transferase levels are associated with the location of acute pulmonary embolism. Cross-sectional evaluation in hospital setting

Assessments of the associations of thrombus localization with accompanying disorders, risk factors, D-dimer levels, and the red cell distribution width in pulmonary embolism

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