The Changing Pattern of Venous Thromboembolic Disease

Cohen, Alexander T.; Edmondson, Robert A.; Phillips, M.; Ward, V.; Kakkar, Vijay V.

doi:10.1159/000217189

Cited by 57 publications

(54 citation statements)

References 9 publications

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“…An autopsy study from Hong Kong documented a rising trend of PE from 1975 to 1989. 32,33 Conversely, the incidence of PE in autopsies reduced in the United States from 1966 to 1980, 34 and in the United Kingdom from 1965 to 2000, 35,36 but a Swedish study indicated that the incidence of PE was unchanged from 1957 to 1987. 37 These differences may be related to differences in clinically diagnostic accuracy, in population structure, in prophylaxis and management of DVT/PE, and in life style.…”

Section: Pe In Children Aged 0-9mentioning

confidence: 99%

Pulmonary Embolism is an Important Cause of Death in Young Adults

Sakuma

Nakamura

Takahashi

et al. 2007

Circ J

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he number of deaths from pulmonary embolism (PE) has been increasing in Japan, 1 and the incidence of PE in autopsy cases is also reported to have increased from 1958 to 1986. 2,3 Population-based analysis shows that deaths from PE are increasing in older age groups but PE is often misdiagnosed. 4,5 There are no reports on the incidence of PE in autopsy cases after 1986 in Japan and the following remain to be solved: (1) to what degree does PE contribute to death in different ages and genders and (2) what factor (s) contributes to diagnosis of PE before death. Therefore, our aims in the present study were to examine the incidence of PE in autopsy cases after 1986, and to clarify these 2 unsolved questions. MethodsThe subjects of the present study included PE cases confirmed by autopsy in Japan between 1987 and 1998. 6-17 We excluded cases of pulmonary microembolism with disseminated intravascular coagulation from our analysis. Circulation Journal Vol.71, November 2007PE was defined as critical (critical PE) when it was the primary cause of death or the main diagnosis and it includes all types of PE. The term "all PE" was used to indicate the total number of thrombotic PEs, tumor PEs, bacterial PEs, mycotic PEs and other emboli (eg, fat, amniotic fluid, etc). 18 To make it possible to compare our data with those reported by Mieno et al, 3 we analyzed our PE cases according to Mieno's criteria in which cases less than 1 year old and those with non-thrombotic PE were excluded. Statistical AnalysisStatistical analysis was performed using SPSS 13.0 (SPSS Inc, Chicago, IL, USA). Non-ordinal categorical data using the chi-square test. The results of the logistic regression models and Poisson regression analysis 19 are presented as estimated odds ratios (ORs) with the corresponding 95% confidence intervals (CIs).Circ J 2007; 71: 1765 -1770 (Received April 18, 2007 revised manuscript received July 9, 2007; accepted July 24, 2007

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Section: Pe In Children Aged 0-9mentioning

confidence: 99%

Pulmonary Embolism is an Important Cause of Death in Young Adults

Sakuma

Nakamura

Takahashi

et al. 2007

Circ J

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“…Recent registries and cohort studies suggest that ,10% of all patients with acute PE die within the first 3 months after diagnosis [3,4]. Of all patients admitted to hospitals, 1% die of acute PE and 10% of all in-hospital deaths are PE-related [2,5,6]. Taken together, these data demonstrate that VTE is a potentially life-threatening disease.…”

mentioning

confidence: 94%

Is it time for home treatment of pulmonary embolism?

Lankeit

Konstantinides

2012

Eur Respir J

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Acute pulmonary embolism (PE) is a frequent cause of death, but not all patients are at high risk of an adverse early outcome. It has been proposed that selected patients may be considered for early discharge and home treatment, but it was only recently that improved risk assessment strategies permitted advances in the identification of low-risk PE.Clinical prediction rules, such as the Pulmonary Embolism Severity Index (PESI), and laboratory biomarkers, particularly natriuretic peptides and cardiac troponins, appeared capable of excluding severe PE and serious comorbidity.Recently, two randomised trials and two prospective cohort studies investigated the feasibility and safety of outpatient treatment. All excluded patients with haemodynamic instability and serious comorbidity, but only one trial used a validated clinical score (PESI) for patient inclusion, and only one cohort study employed a biomarker test. Overall, 90-day outcome was favourable and the results appear promising.To optimise patient selection, future trials will need to test simplified clinical scores combined with high-sensitivity biomarker assays, and it will have to be determined whether echocardiography and/or compression ultrasonography are also required before discharge. Furthermore, ongoing trials will show whether new oral anticoagulants are a safe and cost-effective option for managing patients out of hospital.

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“…In addition acute and chronic illness increases the patient's predisposition to occurrence of thrombosis [4,5]. About 70-80% of fatal pulmonary embolism (PE) cases in the hospital occur in medical (non-surgical) patients [6][7][8]. Therefore patient's DVT risk assessment is necessary in deciding to start thrombosis prophylaxis interventions.…”

Section: Introductionmentioning

confidence: 99%