INTRODUCTION: Acute pulmonary embolism (APE) is an urgent clinical condition that can progress in a wide variety of ways. Therefore, we sought to develop an easy-to-apply algorithm, to be based on readily available clinical indicators, effective in predicting unfavourable outcomes. METHODS: This was a retrospective cohort study based on systematically collected data in a database. The study included 102 patients with APE who were admitted to a tertiary care hospital. The following outcomes were defined as unfavourable: shock, the need for mechanical ventilation, the use of thrombolytics, and death. Logistic regression analysis was used to explore variables significantly associated with outcome and to calculate post-test probabilities. RESULTS: The prevalence of unfavourable outcomes was 25.5% (26 of the 102 patients with APE). The risk of an unfavourable outcome was reduced to 7.0% for patients with APE who were aged ≤ 40 years. In patients with APE who were aged > 40 years, the presence of hypoxaemia (i.e. peripheral oxygen saturation < 90%) alone increased the risk of an unfavourable outcome to 57.0%. A recent history of trauma and the presence of pre-existing lung or heart disease were significantly associated with unfavourable outcomes. The inclusion of those variables in the logistic regression model increased the post-test risk of an unfavourable outcome to 65.0%-86.0%. CONCLUSION: Advanced age (i.e. > 40 years), the presence of hypoxaemia, a recent history of trauma and the presence of pre-existing lung or heart disease are risk factors for unfavourable outcome in patients with APE.
INTRODUCTION: Acute pulmonary embolism (APE) is an urgent clinical condition that can progress in a wide variety of ways. Therefore, we sought to develop an easy-to-apply algorithm, to be based on readily available clinical indicators, effective in predicting unfavourable outcomes. METHODS: This was a retrospective cohort study based on systematically collected data in a database. The study included 102 patients with APE who were admitted to a tertiary care hospital. The following outcomes were defined as unfavourable: shock, the need for mechanical ventilation, the use of thrombolytics, and death. Logistic regression analysis was used to explore variables significantly associated with outcome and to calculate post-test probabilities. RESULTS: The prevalence of unfavourable outcomes was 25.5% (26 of the 102 patients with APE). The risk of an unfavourable outcome was reduced to 7.0% for patients with APE who were aged ≤ 40 years. In patients with APE who were aged > 40 years, the presence of hypoxaemia (i.e. peripheral oxygen saturation < 90%) alone increased the risk of an unfavourable outcome to 57.0%. A recent history of trauma and the presence of pre-existing lung or heart disease were significantly associated with unfavourable outcomes. The inclusion of those variables in the logistic regression model increased the post-test risk of an unfavourable outcome to 65.0%-86.0%. CONCLUSION: Advanced age (i.e. > 40 years), the presence of hypoxaemia, a recent history of trauma and the presence of pre-existing lung or heart disease are risk factors for unfavourable outcome in patients with APE.
Authors: Drahomir Aujesky; D Scott Obrosky; Roslyn A Stone; Thomas E Auble; Arnaud Perrier; Jacques Cornuz; Pierre-Marie Roy; Michael J Fine Journal: Arch Intern Med Date: 2006-01-23
Authors: J L Carson; M A Kelley; A Duff; J G Weg; W J Fulkerson; H I Palevsky; J S Schwartz; B T Thompson; J Popovich; T E Hobbins Journal: N Engl J Med Date: 1992-05-07 Impact factor: 91.245
Authors: Drahomir Aujesky; D Scott Obrosky; Roslyn A Stone; Thomas E Auble; Arnaud Perrier; Jacques Cornuz; Pierre-Marie Roy; Michael J Fine Journal: Am J Respir Crit Care Med Date: 2005-07-14 Impact factor: 21.405
Authors: Jun Sung Lee; Tong Moon; Tae Hoon Kim; Se Young Kim; Jun Young Choi; Kyung Bok Lee; Yu Jin Kwon; Suk Hee Song; Su Hyun Kim; Hae Ok Kim; Ho Kyeong Hwang; Min Ji Kim; Young Kyoung Lee Journal: Vasc Specialist Int Date: 2016-12-31