Pulmonary embolism: retrospective view at known disease
Authors:
Margita Belicová; Milan Ochodnický; Jurina Sadloňová; Dana Prídavková; Marián Mokáň
Authors‘ workplace:
I. Interná klinika JLF UK a UN Martin, Slovenská republika
Published in:
Vnitř Lék 2019; 65(7-8): 475-482
Category:
Original Contributions
Overview
Introduction: Acute pulmonary embolism, usually caused by thromboembolism is still a serious medical problem in spite of technical progress in diagnostics, as well as the enhancements in prophylactic and therapeutic options.
Aim: The evaluation of characteristic, incidence, diagnostic, treatment and mortality rate of patients with pulmonary embolism hospitalized at the 1st Internal Clinic, University Hospital in Martin, within the years 1996–2017.
Methods: The authors offer retrospective analysis of 699 (359 men) patients with pulmonary embolism. Diagnosis was confirmed by angiography, perfusion scan or computed tomography. The data of patients were collected continuously and they are archived at the workplace of the authors.
Results: Patients with explicitly confirmed pulmonary embolism created 1.01 % of all hospitalized patients with average age 60.2. The average age of men was lower compared to women (56.6 vs 65.9). As high-risk pulmonary embolism presented 14.88 %, intermediate-risk 40.77 % and low-risk 44.34 % patients with pulmonary embolism. The source of pulmonary embolism was detected in 46.35 % and risk factors were detected in 52.79 % patients with pulmonary embolism. With thrombolytic therapy were treated 23.18 % of all patient with pulmonary embolism and intracranial bleeding occurred in 0.28 % of them. Early mortality rate was 7.58 % of all patients with pulmonary embolism.
Conclusion: The authors detected increasing occurrence of patients with pulmonary embolism and from 2005 increasing occurrence of non-provoked pulmonary embolism. An average age in the patients with non-provoked pulmonary embolism compared to patients with provoked pulmonary was lower in men (53.5 vs 60.9) as well in women (56 vs 67.7). Patients with non-provoked pulmonary embolism compared to patients with provoked pulmonary were more frequent hospitalized because acute coronary syndrome (5.03 % vs 2.91 %) as well ischemic stroke (7.16 % vs 5.61 %) within one year after pulmonary embolism.
Keywords:
Deep vein thrombosis – Pulmonary embolism – risk factors of venous thrombosis
Sources
- Raja AS, Greenberg JO, Qaseem A et al. Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practise Advice From the Clinical Guidelines of the American College of Physicians Evaluation of Patients With Suspected Acute Pulmonary Embolism. Ann Intern Med 2015; 163(9): 701–711. Dostupné z DOI: <http://dx.doi.org/10.7326/M14–1772>.
- Torbicki A, Perrier A, Konstantinides S et al. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2008; 29(18): 2276–2315. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehn310>.
- Rokyta R, Hutyra M, Jansa P. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Summary document prepared by the Czech Society of Cardiology. Cor et Vasa 2015; 57(4): e275-e296. Dostupné z WWW: <http://www.sciencedirect.com/science/article/pii/S0010865015000600>. Dostupné z DOI: <https://doi.org/10.1016/j.crvasa.2015.05.009>.
- Vavera Z. Plicní embolie ve světle nových doporučení. Interv Akut Kardiol 2015; 14(2): 77–83.
- Šimková I, Jurkovičová O, Gašpar O. Komentár k odporúčaniam Európskej kardiologickej spoločnosti pre diagnostiku a manažment akútnej pľúcnej embólie (2014). Cardiology Lett 2015; 24(6): 417–424.
- Bĕlohlávek J, Dietrich V, Linhart A. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol 2013; 18(2): 129–138.
- Deitelzweig SB, Johnson BH, Lin J et al. Prevalence of clinical venous thromboembolism in the USA: current trends and future projections. Am J Hematol 2011; 86(2): 217–220. Dostupné z DOI: <http://dx.doi.org/10.1002/ajh.21917>.
- Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999; 353(9162): 1386–1389. Dostupné z DOI: <http://dx.doi.org/10.1016/s0140–6736(98)07534–5>.
- Costantino G, Ruwald MH, Quinn J et al. Prevalence of Pulmonary Embolism in Patients With Syncope. JAMA Intern med 2018; 178(3): 356–362. <http://dx.doi.org/10.1001/jamainternmed.2017.8175>.
- Konstantinides SV, Barco S, Lankei M et al. Management of Pulmonary Embolism: An Update. J Am Coll Cardiol 2016; 67(8): 976–990. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2015.11.061>.
- Konstantinides SV, Torbicki A, Agnelli G et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 2014; 35(43): 3033–3080. Dostupné z DOI: <https://doi.org/10.1093/eurheartj/ehu283>.
- Righini M, Le Gal G, Aujesky D et al. Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial. Lancet 2008; 371(9621): 1343–1352. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(08)60594–2>.
- Belicová M, Kňazeje M, Lojdlová M et al. Pľúcna embolia, zdlhavá diagnóza u mladého muža. Vnitř Lék 2004; 50(10): 793–798.
- Chlumský J. Tromboza horní končetiny u nemocné s deficitem proteinu C. Vnitř Lék 2001; 47(2): 115–116.
- Ogren M, Bergqvist D, Eriksson H et al. Prevalence and risk of pulmonary embolism in patients with intracardiac thrombosis: a population-based study of 23 796 consecutive autopsies. Eur Heart J 2005; 26(11): 1108–1114. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehi130>.
- Torbicki A, Galie N, Covezzoli A et al. Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry. J Am Coll Cardiol 2003; 41(12): 2245–2251. Dostupné z DOI: <http://dx.doi.org/10.1016/s0735–1097(03)00479–0>.
- Meyer G, Vicaut E, Danays T et al. [PEITHO Investigators]. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014; 370(15): 1402–1411. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1302097>.
- Konstantinides SV, Vicaut E, Danays T et al. Impact of thrombolytic therapy on the long-term outcome of intermediate-risk pulmonary embolism. J Am Coll Cardiol 2017; 69(12): 1536–1544. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2016.12.039>.
- Yamamoto T. Management of patients with high-risk pulmonary embolism: a narrative review. J Intensive Care 2018;6:16. Dostupné z DOI: <http://dx.doi.org/10.1186/s40560–018–0286–8>.
- Cushman M, Tsai AW, White RH et al. Deep vein thrombosis and pulmonary embolism in two cohorts: The longitudinal investigation of thromboembolism etiology. Am J Med 2004; 117(1): 19. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2004.01.018>.
- Henriksson P, Westerlund E, Wallén H et al. Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertillisation: crosss sectional study. BMJ 2013; 346: e8632. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.e8632>.
- Andrei MC, Andercou A. Is there a Link Between Atherothrombosis and Deep Venous Thrombosis? Maedica (Buchar) 2014; 9(1): 94–97.
- Sorensen HT, Horvath-Puho E, Pedersen L et al. Venous thromboembolism and subsequent hospitalisation due to acute arterial cardiovascular events: a 20-year cohort study. Lancet 2007; 370(9601): 1773–1779. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(07)61745–0>.
- Borohovitz A, Weinberg MD, Weinberg I. Pulmonary embolism: Care standards in 2018. Prog Cardiovasc Dis. 2018; 60(6): 613–621. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pcad.2017.12.005>.
- Poredoš H. Interrelationship between venous and arterial thrombosis. Int Angiol 2017; 36(4): 295–298. Dostupné z DOI: <http://dx.doi.org/10.23736/S0392–9590.17.03820–2>.
- Franchini M, Mannucci PM. Association between venous and arterial thrombosis: clinical implications. Eur J Intern Med 2012; 23(4): 333–337. <http://dx.doi.org/10.1016/j.ejim.2012.02.008>.
- Jezovnik MK, Poredoš P, Lusa L. Idiopathic venous thrombosis is associated with preclinical atherosclerosis. J Atheroscler Thromb 2010; 17(3)3: 304–311. Dostupné z DOI: <http://dx.doi.org/10.5551/jat.3079>.
- Khan F, Vaillancourt C, Carrier M. Should we screen extensively for cancer after unprovoked venous thrombosis? BMJ 2017; 356:j1081. Dostupné z DOI: <https://doi.org/10.1136/bmj.j1081>.
- Plameňová I, Bartošová L, Chudej J et al. Národný register trombofilných stavov v Slovenskej republike. Vask med 2011; 3(2): I-V.
- Staško J, Dobrotová M, Ivanková J et al. Syndróm lepivých doštičiek – súčasný stav a perspektívy. Interv Akut Kardiol 2017; 16(2): 56–60.
- Lang I, Simonneau G, Pepke-Zaba JW et al. Factors associated with diagnosis and operabillity of chronic thromboembolic pulmonary hypertension. A case-control study. Thromb Haemostat 2013; 110(1): 83–91. Dostupné z DOI: <http://dx.doi.org/10.1160/TH13–02–0097>.
- Root CW, Dudzinski DM, Zakhary B et al. Multidisciplinary approach to the management of pulmonary embolism patients: the pulmonary embolism response team (PERT). J Multidiscip Healthc 2018; 11: 187–195. Dostupné z DOI: <http://dx.doi.org/10.2147/JMDH.S151196>.
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Internal Medicine
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