Pulmonary embolism – does Diabetes Mellitus represent a risk?


Authors: MUDr. Dana Weberová 1;  prof. MUDr. Pavel Weber, CSc. 1;  prof. MUDr. Hana Matějovská Kubešová, CSc. 1;  MUDr. Hana Meluzínová 1;  MUDr. Katarína Bielaková, Ph.D. 1;  MUDr. Vlasta Polcarová 1;  MUDr. Tomáš Nebeský 2;  MUDr. Lubomír Mrhač 2
Authors‘ workplace: Klinika interní, geriatrie a praktického lékařství, LF MU a FN Brno 1;  Klinika radiologie a nukleární medicíny, LF MU a FN Brno 2
Published in: Geriatrie a Gerontologie 2018, 7, č. 4: 141-146
Category:

Overview

Introduction: Venous thromboembolism is the third most common cardiovascular disease. About 1.0 % of patients admitted to hospital die of pulmonary embolism. The aim of our study was to analyze the set of patients above 65 years old in 2005-2012 manifesting PE.

Patients and Methods: In the years 2005-2012 we hospitalized 9352 patients at our clinic of Internal Medicine and Geriatrics, with average age of 79.9 ± 8.5 years old (ranging between 65-103 years old). 3090 of these were diabetics. Acute pulmonary embolism was determined in 269 patients with average age of 80.3 ± 4.7 years old. Though 95 patients of these died (35.3 %), 174 (64.7 %) survived. Furthermore, 70 patients from our studied pulmonary embolism set were diabetics and 199 patients were non-diabetics.

Results: The prevalence of pulmonary embolism among in-patients above 65 years old was 2.9 %. The mortality rate of pulmonary embolism among all patients admitted to our clinic was 1.0 %. We found a higher prevalence of this disease in non-diabetics set (3.1 %) compared with diabetics (2.3 %) (p < 0.025). Diabetic patients with pulmonary embolism were younger than the non-diabetics. Which means that the average age of diabetics was 78.1 ± 6.8 years old vs. non-diabetics 80.4 ± 7.4 years old (p < 0.010). Furthermore, in terms of the risk factors for pulmonary embolism, we found obesity significantly more frequently among diabetics both among the surviving and the deceased (p < 0.001 and p < 0.050) in comparison to the non-diabetics. Generally, the most important risk factor for pulmonary embolism in the whole set (with or without diabetes mellitus) was immobility. One risk factor was more common in the surviving non-diabetics compared with the diabetics (p < 0.050). Whereas three risk factors occurred simultaneously more frequently in the surviving diabetics with pulmonary embolism (p < 0.001).

Conclusion: Despite the presence of more coincident risk factors by the diabetics, the prevalence of pulmonary embolism was more frequent in the non-diabetics set. Nevertheless, we had not found fundamental contradiction in the mortality of pulmonary embolism in both sets. Generally, the crucial risk factor of pulmonary embolism in old age remains immobility, regardless of diabetes mellitus. In the diabetics set is furthermore followed with obesity.

Keywords:

obesity – old age – Pulmonary embolism – Venous thromboembolism – immobility – Anticoagulant therapy


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Labels
Geriatrics General practitioner for adults Orthopaedic prosthetics
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