Systematic Review and Meta-analysis of Outcomes of Patients With Subsegmental Pulmonary Embolism With and Without Anticoagulation Treatment

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Adam BariteauJeffrey A Kline

Abstract

This systematic review addresses the controversy over the decision to anticoagulate patients with subsegmental pulmonary embolism (SSPE). We searched Ovid MEDLINE, PubMed, Embase, the Cochrane Library, Scopus, Web of Science, ClinicalTrials.gov, Google Scholar, and bibliographies in March 2017. Two authors reviewed and retained papers with symptomatic patients who underwent computerized tomographic pulmonary angiography and had sufficient information to determine SSPE; decision to treat (or not) with systemic anticoagulation; and outcomes of bleeding, venous thromboembolism (VTE) recurrence, and death. Papers were assessed for selection and publication bias and heterogeneity, with Eggers and the inconsistency indexes (I2 ). From 1,512 papers screened, we included 14 studies comprising 15,563 patients for full-length review and analysis. Pooled data demonstrated I2  = 99% with an Eggers p < 0.001, suggesting significant publication bias. The pooled prevalence of SSPE was 4.6% (95% confidence interval [CI] = 1.8%-8.5%). The frequency of bleeding in SSPE patients treated with anticoagulation (n = 589) was 8.1% (95% CI = 2.8%-15.8%), with no available bleeding data in untreated patients (n = 126). The frequency of VTE recurrence wi...Continue Reading

References

Jul 12, 2002·Statistics in Medicine·Julian P T Higgins, Simon G Thompson
Apr 26, 2006·Journal of Thrombosis and Haemostasis : JTH·G Le GalF Couturaud
Jan 30, 2010·Respiration; International Review of Thoracic Diseases·Seung-Ick ChaTae-Hoon Jung
Apr 20, 2011·Journal of Thrombosis and Haemostasis : JTH·M CarrierM A Rodger
Oct 19, 2011·Annals of Internal Medicine·Penny F WhitingUNKNOWN QUADAS-2 Group
Mar 26, 2013·AJR. American Journal of Roentgenology·Ayaz AghayevKyongtae T Bae
Sep 17, 2014·JAMA : the Journal of the American Medical Association·Lana A CastellucciMarc Carrier
Nov 27, 2014·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Federico AngrimanWilliam M Vollmer
Dec 3, 2014·Journal of Thrombosis and Haemostasis : JTH·J GoyM Crowther
Dec 15, 2015·Der Anaesthesist·C KochC Lichtenstern

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Citations

Sep 19, 2019·The New England Journal of Medicine·Amanda FernandesMarc Carrier
Aug 8, 2020·BMJ : British Medical Journal·Lisa DuffettMelissa A Forgie
Feb 8, 2020·The Cochrane Database of Systematic Reviews·Hugo Hb YooPaulo J Fortes Villas Boas
Dec 15, 2020·Research and Practice in Thrombosis and Haemostasis·Paul L den ExterFrederikus A Klok
Feb 5, 2021·Research and Practice in Thrombosis and Haemostasis·Christine Baumgartner, Tobias Tritschler
Feb 19, 2021·Blood Advances·Melissa YanCristhiam M Rojas-Hernandez
Mar 15, 2021·Archivos de bronconeumología·José Luis LoboUNKNOWN en nombre del Panel Multidisciplinar para el Manejo de la TEP
Oct 13, 2020·The American Journal of Emergency Medicine·Jatin NarangSharon E Mace
Dec 7, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Nicholas D KlemenBarry Hashimoto

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