Prognostic significance of early diagnosis in acute pulmonary thromboembolism with circulatory failure

Despite the advances in our understanding of venous thromboembolic disease, the prevalence of pulmonary thromboembolism (PTE) at autopsy has not changed over 3 decades. When patients survive long enough to have a diagnosis of massive PTE and start receiving treatment, the outlook is considered to be...

Full description

Saved in:
Bibliographic Details
Published in:Heart and vessels 2002-11, Vol.17 (1), p.7-11
Main Authors: Ota, Masahiro, Nakamura, Mashio, Yamada, Norikazu, Yazu, Takahiro, Ishikura, Ken, Hiraoka, Naoto, Tanaka, Hideki, Fujioka, Hirofumi, Isaka, Naoki, Nakano, Takeshi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Cardiovascular disease
Clinical outcomes
Embolectomy
Female
Hospital Mortality
Humans
Japan
Logistic Models
Male
Medical diagnosis
Middle Aged
Mortality
Prognosis
Pulmonary Embolism - diagnosis
Pulmonary Embolism - mortality
Pulmonary Embolism - physiopathology
Recurrence
Retrospective Studies
Shock - complications
Survival Analysis
Thrombolytic Therapy
Time Factors
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Despite the advances in our understanding of venous thromboembolic disease, the prevalence of pulmonary thromboembolism (PTE) at autopsy has not changed over 3 decades. When patients survive long enough to have a diagnosis of massive PTE and start receiving treatment, the outlook is considered to be moderately good. However, the diagnosis is often difficult to obtain and is frequently missed. We hypothesize that mortality of acute PTE is reduced by early diagnosis. Eighty-five patients with acute PTE with circulatory failure who survived 1 h after the onset were divided into two groups: the early Dx group consisted of the patients whose disease was diagnosed as acute PTE within 24 h of the onset, and the Late Dx group included patients whose disease was not diagnosed within 24 h of onset, or died without clinical diagnosis between 1 and 24 h after the onset. Overall mortality was significantly low in the Early Dx group compared with that of the Late Dx group (21.6% vs 67.6%, P < 0.0001). Multiple logistic regression analysis demonstrated that a reduction in in-hospital mortality was associated with early diagnosis (odds ratio for in-hospital death, 0.094; 95% confidence interval, 0.03-0.33). The results of our study suggested that early diagnosis might favorably affect the in-hospital clinical outcome of hemodynamically unstable patients with acute PTE.
ISSN:0910-8327
1615-2573
DOI:10.1007/s003800200036