Prognostic importance of central thrombus in hemodynamically stable patients with pulmonary embolism
| Autor: | Sevinc Sarinc Ulasli, Servet Kayhan, Serap Duru, Ebru Çakır, Aygül Güzel, Aysegul Senturk, Ezgi Demirdogen, Fatih Yakar, Serdar Berk, Savas Ozsu |
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| Přispěvatelé: | RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kayhan, Servet, Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı., Demirdöǧen, Ezgi, AAH-9812-2021, OMÜ, [Senturk, Aysegul] Ankara Ataturk Training & Res Hosp, Dept Pulm Med, TR-06800 Ankara, Turkey -- [Ozsu, Savas] Karadeniz Tech Univ, Sch Med, Dept Pulm Med, Trabzon, Turkey -- [Duru, Serap] Ankara Diskapi Training & Res Hosp, Dept Pulm Med, Ankara, Turkey -- [Cakir, Ebru] Trakya Univ, Sch Med, Dept Pulm Med, Edirne, Turkey -- [Ulasli, Sevinc Sarinc] Afyon Kocatepe Univ, Sch Med, Dept Pulm Med, Afyon, Turkey -- [Demirdogen, Ezgi] Uludag Univ, Sch Med, Dept Pulm Med, Bursa, Turkey -- [Kayhan, Servet] Recep Tayyip Erdogan Univ, Sch Med, Dept Pulm Med, Rize, Turkey -- [Guzel, Aygul] 19 Mayis Univ, Sch Med, Dept Pulm Med, Samsun, Turkey -- [Yakar, Fatih] Bezmi Alem Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey -- [Berk, Serdar] Cumhuriyet Univ, Sch Med, Dept Pulm Med, Sivas, Turkey |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Hemoptysis Chi square distribution Turkey Epidemiology Peripheral occlusive artery disease Procedures Time factor 0302 clinical medicine Observational study Medicine Treatment outcome Aged 80 and over General Medicine Central thrombus Multicenter study Clinical trial cardiovascular system Diagnostic imaging Lung embolism Cardiology and Cardiovascular Medicine Combİnatİon Anticoagulant agent Human medicine.medical_specialty Metaanalysİs Burden Major clinical study Article Fibrinolytic therapy Multidetector computed tomography 03 medical and health sciences Thrombolysİs medicine.artery Faintness Humans Aged Time factors Computed tomographic angiography Pulmonary embolism Very elderly Follow up medicine.disease Pulmonary artery Thrombolytic therapy Dyspnea 030228 respiratory system Risk factors Bİomarkers Computed tomography angiography Comparative study Risk factor Cardiac & cardiovascular systems 030204 cardiovascular system & hematology Lung Embolism Embolectomy Blood Clot Lysis Hemodynamically stable Fibrinolytic agents Heparin low-molecular-weight Middle aged Thorax pain Low molecular weight heparin Mortality rate Multidetector ct Heparin Odds ratio Cardiology Female Radiology Thrombus medicine.drug Adult Proportional hazards models medicine.drug_class Fibrinolytic agent Proportional hazards model Pathophysiology Anticoagulation Internal medicine Computer assisted tomography cardiovascular diseases Prospective study Mortality Emergency-department Risk stratİfİcatİon business.industry Hemodynamics Anticoagulants Thrombosis Arterial occlusive diseases Chi-square distribution Cardiovascular system & cardiology Young adult Multivariate analysis Therapy business Heparİn Controlled study |
| Popis: | WOS: 000414152700007 PubMed ID: 28248408 Background: The association between mortality and localization of central thrombus in hemodynamically stable patients with pulmonary embolism (PE) is unclear. Sufficient data are not available to help clinicians to select between low molecular weight heparin (LMWH), unfractionated heparin (UFH) and thrombolytics for the management of central thrombus. The present study aims to investigate whether central thrombus in the pulmonary artery affects 30-day mortality rate, and to compare the outcomes of different treatment approaches in patients with central thrombus. Methods: This multi-central, prospective, observational study included 874 hemodynamically stable patients with PE confirmed by multidetector computed tomography scan. The localization of the emboli was evaluated and categorized as central (saddle or at least one main pulmonary artery), lobar or distal. The primary study outcome was 30-day all-cause mortality. Results: Localization of the emboli was central in 319 (36.5%) patients, lobar in 264 (30.2%) and distal in 291 (33.2%) patients. Seventy-four (8.5%) patients died during the 30-day follow-up period. All-cause mortality rate was 11.9%, 6.8% and 6.2% in patients with central, lobar, and distal emboli, respectively (p < 0.001). Multivariate analysis did not show that hemodynamically stable central thrombus was an independent predictor of mortality. Additionally, mortality rate was not significantly different between UFH, LMWH and thrombolytic therapy groups. Conclusions: The present study showed that central thrombus was not an independent predictor of mortality in hemodynamically stable PE patients. LMWH and UFH were similarly effective in the treatment of this patient group. |
| Databáze: | OpenAIRE |
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