Diagnosis and therapy of pulmonary embolism prior to death

Deutsche medizinische Wochenschrift
A ReissigC Kroegel

Abstract

The study was conducted to assess the rate of suspected pulmonary embolism (PE) prior to death and the diagnostic and therapeutic procedures performed. Patients with autopsy-confirmed PE between 1998 and 2002 were included. Autopsy register and medical records were reviewed for history, diagnosis and therapy of PE. Patients were categorised into fatal and non-fatal PE according to the autopsy findings. 102 patients with fatal and 247 patients with non-fatal PE were eligible for analysis (median age 68 years; 24-95). In 58.8% with fatal and in 32% with non-fatal PE, disease was suspected pre-mortal. Clinical suspicion of PE was significantly enhanced in venous thrombosis (Odds Ratio [OR] = 12.17, p=0.004) and significantly decreased for chronic vascular disease (OR = 0.30, p=0.002). Recurrent PE was demonstrated in 31.4% fatal and in 4.5% non-fatal PE (OR = 9.81, p=0.001). 7% of all PE were localised centrally, 19% centrally and peripherally and 74% peripherally. Dyspnoea and tachycardia were the most frequent symptoms in fatal PE. About half of all patients suffered from malignancies. Suspicion of PE decreased after day 14 of hospitalisation (OR = 0.33, p=0.021). PE often is not diagnosed pre-mortally. Patients with chronic vas...Continue Reading

Citations

Jun 12, 2013·European Journal of Nuclear Medicine and Molecular Imaging·Carl Schuemichen
Mar 16, 2013·Polish journal of radiology·Dominik SierońChristian Stroszczynski
Sep 28, 2018·Current Cardiology Reports·Jonathan Halevy, Mary Cushman

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