Risk stratification of patients with acute symptomatic pulmonary embolism

Internal and Emergency Medicine
David JiménezR D Yusen

Abstract

Patients with acute symptomatic pulmonary embolism (PE) who present with arterial hypotension or shock have a high risk of death (high-risk PE), and treatment guidelines recommend strong consideration of thrombolysis in this setting. For normotensive patients diagnosed with PE, risk stratification should aim to differentiate the group of patients deemed as having a low risk for early complications (all-cause mortality, recurrent venous thromboembolism, and major bleeding) (low-risk PE) from the group of patients at higher risk for PE-related complications (intermediate-high risk PE), so low-risk patients could undergo consideration of early outpatient treatment of PE and intermediate-high risk patients would undergo close observation and consideration of thrombolysis. Clinicians should also use risk stratification and eligibility criteria to identify a third group of patients that should not undergo escalated or home therapy (intermediate-low risk PE). Such patients should initiate standard therapy of PE while in the hospital. Clinical models [e.g., Pulmonary Embolism Severity Index (PESI), simplified PESI (sPESI)] may accurately identify those at low risk of dying shortly after the diagnosis of PE. For identification of interm...Continue Reading

References

Feb 8, 2003·BMJ : British Medical Journal·Karin JanataMarcus Müllner
Jun 20, 2003·Circulation·Richard H White
Jul 16, 2005·The American Journal of Cardiology·Tudor ScridonScott D Solomon
Jul 16, 2005·American Journal of Respiratory and Critical Care Medicine·Drahomir AujeskyMichael J Fine
Oct 7, 2005·European Heart Journal·Drahomir AujeskyMichael J Fine
Jan 25, 2006·Archives of Internal Medicine·Drahomir AujeskyMichael J Fine
Dec 21, 2007·The European Respiratory Journal·D JiménezR D Yusen
Nov 17, 2009·American Journal of Respiratory and Critical Care Medicine·Olivier SanchezGuy Meyer
Jan 30, 2010·American Journal of Respiratory and Critical Care Medicine·David JiménezUNKNOWN RIETE Investigators
Jun 30, 2010·European Heart Journal·Mareike LankeitEvangelos Giannitsis
Aug 11, 2010·Archives of Internal Medicine·David JiménezUNKNOWN RIETE Investigators
Oct 20, 2010·British Journal of Haematology·David JiménezRoger D Yusen
Mar 23, 2011·Circulation·Michael R JaffUNKNOWN American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology
Jun 8, 2011·Journal of Thrombosis and Haemostasis : JTH·W ZondagUNKNOWN Hestia Study Investigators
Aug 20, 2011·Chest·Mareike LankeitUNKNOWN Instituto Ramón y Cajal de Investigación Sanitaria Pulmonary Embolism Study Group
Sep 3, 2011·Journal of Thrombosis and Haemostasis : JTH·D SánchezD Jiménez
Nov 22, 2012·The American Journal of Cardiology·Luis V PaivaAntónio L Marques
Jan 30, 2014·American Journal of Respiratory and Critical Care Medicine·David Jiménez On Behalf Of The Protect Investigators
Apr 4, 2014·The European Respiratory Journal·Carlo BovaDavid Jiménez
Apr 11, 2014·The New England Journal of Medicine·Guy MeyerUNKNOWN PEITHO Investigators
Apr 29, 2014·Journal of Thrombosis and Haemostasis : JTH·J L LoboUNKNOWN PROTECT and RIETE investigators
Feb 15, 2015·The American Journal of Medicine·Felix G MeinelFabian Bamberg

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Citations

Jul 9, 2016·International Journal of Cardiology·Mihaela CordeanuDominique Stephan
Mar 24, 2017·Thrombosis and Haemostasis·Madhvi RajpurkarNeil A Goldenberg
Jun 6, 2017·Expert Review of Respiratory Medicine·Cécile TromeurMenno V Huisman
Nov 14, 2018·Annals of Internal Medicine·David R VinsonUNKNOWN eSPEED Investigators of the KP CREST Network
Feb 8, 2019·Journal of Thrombosis and Thrombolysis·Phil WellsConcetta Crivera
Jun 14, 2019·Physiological Measurement·Haipeng LiuFei Chen
Dec 28, 2016·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Begüm ErganNecati Gökmen
Apr 8, 2019·Journal of Health Economics and Outcomes Research·Li WangConcetta Crivera
May 29, 2018·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Marta KozlowskaPiotr Pruszczyk
May 31, 2019·International Journal of Cardiology·Martin MurgierUNKNOWN RIETE Investigators
Jun 9, 2021·Medical & Biological Engineering & Computing·Yu-Ching LeeChing-Wei Wang
Sep 1, 2021·Critical Care : the Official Journal of the Critical Care Forum·Tatiana WeinsteinShari B Brosnahan

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