Thomas M Berghaus1, W von Scheidt, M Schwaiblmair. 1. Department of Cardiology, Pneumology, Intensive Care and Endocrinology, Klinikum Augsburg, Academic Teaching Hospital of the Ludwig-Maximilians-University Munich, Stenglinstrasse 2, 86156, Augsburg, Germany. thomas.berghaus@klinikum-augsburg.de
Abstract
BACKGROUND: Early diagnosis can be life-saving in acute pulmonary embolism (PE). It is unknown, whether patients with recurrent PE are diagnosed earlier than those with their first episode. METHODS: Admission data of patients with symptomatic acute PE were reviewed over a period of 47 months. Delay in diagnosis, demographics, body mass index, comorbidity, mortality, risk factors for venous thromboembolism and socio-economic status were recorded. RESULTS: 56 out of 248 patients had recurrent PE, 192 patients were hospitalized because of their first episode. Delay in diagnosis after symptom onset was significantly greater in patients with recurrent than in patients with their first PE (3.4 ± 2.3 vs. 2.2 ± 1.7 days, p = 0.006). Recurrent PE was significantly more often unprovoked (p < 0.001); by contrast, preceding trauma or surgery were significantly (p = 0.007) more frequent in first PE. CONCLUSIONS: Missing predisposing factors in unprovoked PE might explain the greater delay in diagnosis in recurrent PE. Physicians should focus more on informing patients about the possibility of PE recurrence and associated symptoms and thereby enable earlier diagnosis in recurrent PE.
BACKGROUND: Early diagnosis can be life-saving in acute pulmonary embolism (PE). It is unknown, whether patients with recurrent PE are diagnosed earlier than those with their first episode. METHODS: Admission data of patients with symptomatic acute PE were reviewed over a period of 47 months. Delay in diagnosis, demographics, body mass index, comorbidity, mortality, risk factors for venous thromboembolism and socio-economic status were recorded. RESULTS: 56 out of 248 patients had recurrent PE, 192 patients were hospitalized because of their first episode. Delay in diagnosis after symptom onset was significantly greater in patients with recurrent than in patients with their first PE (3.4 ± 2.3 vs. 2.2 ± 1.7 days, p = 0.006). Recurrent PE was significantly more often unprovoked (p < 0.001); by contrast, preceding trauma or surgery were significantly (p = 0.007) more frequent in first PE. CONCLUSIONS: Missing predisposing factors in unprovoked PE might explain the greater delay in diagnosis in recurrent PE. Physicians should focus more on informing patients about the possibility of PE recurrence and associated symptoms and thereby enable earlier diagnosis in recurrent PE.
Authors: R D Hull; G E Raskob; J Hirsh; R M Jay; J R Leclerc; W H Geerts; D Rosenbloom; D L Sackett; C Anderson; L Harrison Journal: N Engl J Med Date: 1986-10-30 Impact factor: 91.245
Authors: M Miniati; R Prediletto; B Formichi; C Marini; G Di Ricco; L Tonelli; G Allescia; M Pistolesi Journal: Am J Respir Crit Care Med Date: 1999-03 Impact factor: 21.405
Authors: Jürgen Leick; Christoph Liebetrau; Sebastian Szardien; Matthias Willmer; Johannes Rixe; Holger Nef; Andreas Rolf; Christian Hamm; Helge Möllmann Journal: Clin Res Cardiol Date: 2012-06-12 Impact factor: 5.460