Clinical Syndromes and Clinical Outcome in Patients With Pulmonary Embolism
| Autor: | F. Conget, Felipe Aizpuru, Manuel Monreal, José Luis Lobo, Vanesa Zorrilla, Fernando Uresandi, Ferrán García-Bragado |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Circulatory collapse medicine.drug_class Vascular disease Pulmonary Infarction business.industry Respiratory disease Low molecular weight heparin Critical Care and Intensive Care Medicine medicine.disease Surgery Pulmonary embolism Venous thrombosis Internal medicine Heart failure medicine Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 130:1817-1822 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.130.6.1817 |
| Popis: | Introduction The influence of the clinical syndromes of pulmonary embolism (PE) on clinical outcome has not been evaluated. Patients and methods The Registro Informatizado de la Enfermedad TromboEmbolica (RIETE) is an ongoing registry of consecutive patients with acute venous thromboembolism. In this study, all enrolled patients with acute PE without preexisting cardiac or pulmonary disease were classified into three clinical syndromes: pulmonary infarction, isolated dyspnea, or circulatory collapse. Their clinical characteristics, laboratory findings, and 3-month outcomes were compared. Results As of January 2005, 4,145 patients with acute, symptomatic, objectively confirmed PE have been enrolled in RIETE. Of them, 3,391 patients (82%) had no chronic lung disease or heart failure: 1,709 patients (50%) had pulmonary infarction, 1,083 patients (32%) had isolated dyspnea, and 599 patients (18%) had circulatory collapse. Overall, 149 patients (4.4%) died during the first 15 days of therapy: 2.5% with pulmonary infarction, 6.2% with isolated dyspnea (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.7 to 3.8), and 6.5% with circulatory collapse (OR, 2.7; 95% CI, 1.7 to 4.2). From days 16 to 90, 31 patients had recurrent PE; 5 of 14 patients (36%) with pulmonary infarction died of their new PE, compared with 5 of 10 patients (50%) with isolated dyspnea, and all 7 patients (100%) with circulatory collapse. Conclusions PE patients with pulmonary infarction (50% of the whole series) had a significantly lower mortality rate both during initial therapy and after discharge. |
| Databáze: | OpenAIRE |
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