Yaser Jenab1, Mohammad Javad Alemzadeh-Ansari2, Seyedeh Arezoo Fehri3, Neda Ghaffari-Marandi3, Arash Jalali4. 1. Emergency Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: There is limited information on the extent and clinical importance of the delay in hospital presentation of acute pulmonary thromboembolism (PTE). OBJECTIVE: The aim of this study was to investigate the delay in hospital presentation of PTE and its association with clinical and imaging findings in PTE. METHODS: This prospective study was conducted on patients admitted to our hospital with a diagnosis of acute PTE between September 2007 and September 2011. Relationships between delay in hospital presentation and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. RESULTS: Of the 195 patients enrolled, 84 (43.1%) patients presented 3 days after the onset of symptoms. Patients with chest pain, history of immobility for more than 3 days, recent surgery, and estrogen use had significantly less delayed presentation. Right ventricular dysfunction was significantly more frequent in patients with delayed presentation (odds ratio [OR] = 2.38; 95% confidence interval [CI] 1.27-4.44; p = 0.006); however, no relationship was found between delay in presentation and pulmonary computed tomographic angiography or color Doppler sonography findings. Patients with delayed presentation were at higher risk of in-hospital mortality (OR = 4.32; 95% CI 1.12-16.49; p = 0.021). CONCLUSIONS: Our study showed that a significant portion of patients with acute PTE had delayed presentation. Also, patients with delayed presentation had worse echocardiographic findings and higher in-hospital mortality.
BACKGROUND: There is limited information on the extent and clinical importance of the delay in hospital presentation of acute pulmonary thromboembolism (PTE). OBJECTIVE: The aim of this study was to investigate the delay in hospital presentation of PTE and its association with clinical and imaging findings in PTE. METHODS: This prospective study was conducted on patients admitted to our hospital with a diagnosis of acute PTE between September 2007 and September 2011. Relationships between delay in hospital presentation and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. RESULTS: Of the 195 patients enrolled, 84 (43.1%) patients presented 3 days after the onset of symptoms. Patients with chest pain, history of immobility for more than 3 days, recent surgery, and estrogen use had significantly less delayed presentation. Right ventricular dysfunction was significantly more frequent in patients with delayed presentation (odds ratio [OR] = 2.38; 95% confidence interval [CI] 1.27-4.44; p = 0.006); however, no relationship was found between delay in presentation and pulmonary computed tomographic angiography or color Doppler sonography findings. Patients with delayed presentation were at higher risk of in-hospital mortality (OR = 4.32; 95% CI 1.12-16.49; p = 0.021). CONCLUSIONS: Our study showed that a significant portion of patients with acute PTE had delayed presentation. Also, patients with delayed presentation had worse echocardiographic findings and higher in-hospital mortality.
Authors: Federica Melazzini; Margherita Reduzzi; Silvana Quaglini; Federica Fumoso; Marco Vincenzo Lenti; Antonio Di Sabatino Journal: Front Med (Lausanne) Date: 2021-04-30