Delayed anticoagulation is associated with poor outcomes in high-risk acute pulmonary embolism

Journal of Critical Care
Sarah SohSungwon Na

Abstract

Early diagnosis and timely treatment are essential to improve the outcomes of pulmonary embolism (PE), but no study has investigated the impact of anticoagulation timing on clinical outcomes in high-risk acute PE patients. We analyzed the relationship between early anticoagulation initiation and in-hospital mortality in high-risk acute PE patients at the intensive care unit (ICU) of a teaching hospital. Seventy-three PE patients admitted to the ICU were included in this retrospective study. Demographic, clinical, radiological, and therapeutic data were collected on ICU admission, and the timings of diagnosis and anticoagulation initiation were analyzed. The number of survivors was 67. The median time from hospital arrival to the start of anticoagulation therapy was significantly lower in survivors (3.6 [2.6-5.0] hours) than nonsurvivors (5.7 [4.5-14.9] hours; P = .03). However, the median time required to achieve a therapeutic anticoagulation level was comparable between survivors and nonsurvivors (12.0 [9.5-19.5] vs 16.4 [10.7-27.4] hours; P = .488). Ventilatory support and vasopressor use were found to be associated with higher in-hospital mortality. Delayed anticoagulation is an important prognostic factor of poor outcomes i...Continue Reading

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Citations

Oct 19, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christiana K PrucnalChristopher Kabrhel
Jul 21, 2020·Research and Practice in Thrombosis and Haemostasis·Stephan NoppCihan Ay
Dec 28, 2016·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Begüm ErganNecati Gökmen

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