Temporal trends in management and outcome of pulmonary embolism: a single-centre experience
| Autor: | Mareike Lankeit, Nina I.J. Rogge, Karl-Patrik Kresoja, Lukas Hobohm, Burkert Pieske, Stavros Konstantinides, Matthias Ebner, Karsten Keller, Gerd Hasenfuß |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Risk medicine.medical_specialty Administration Oral 030204 cardiovascular system & hematology Lower risk Anticoagulation 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Hospital Mortality Registries 030212 general & internal medicine Early discharge Risk assessment Aged Original Paper business.industry Mortality rate Pulmonary embolism Anticoagulants General Medicine Guideline Length of Stay Middle Aged medicine.disease 3. Good health Single centre Cohort Cardiology Trends Female Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | Clinical Research in Cardiology |
| Popis: | Background Real-world data on the impact of advances in risk-adjusted management on the outcome of patients with pulmonary embolism (PE) are limited. Methods To investigate temporal trends in treatment, in-hospital adverse outcomes and 1-year mortality, we analysed data from 605 patients [median age, 70 years (IQR 56–77) years, 53% female] consecutively enrolled in a single-centre registry between 09/2008 and 08/2016. Results Over the 8-year period, more patients were classified to lower risk classes according to the European Society of Cardiology (ESC) 2014 guideline algorithm while the number of high-risk patients with out-of-hospital cardiac arrest (OHCA) increased. Although patients with OHCA had an exceptionally high in-hospital mortality rate of 59.3%, the rate of PE-related in-hospital adverse outcomes (12.2%) in the overall patient cohort remained stable over time. The rate of reperfusion treatment was 9.6% and tended to increase in high-risk patients. We observed a decrease in the median duration of in-hospital stay from 10 (IQR 6–14) to 7 (IQR 4–15) days, an increase of patients discharged early from 2.1 to 12.2% and an increase in the use of non-vitamin K-dependent oral anticoagulants (NOACs) from 12.6 to 57.2% in the last 2 years (09/2014–08/2016) compared to first 6 years (09/2008–08/2014). The 1-year mortality rate (16.9%) remained stable throughout the study period. Conclusion In-hospital adverse outcomes and 1-year mortality remained stable despite more patients with OHCA, shorter in-hospital stays, more patients discharged early and a more frequent NOAC use. Electronic supplementary material The online version of this article (10.1007/s00392-019-01489-9) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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