Fatal pulmonary embolism in hospitalized patients: a large autopsy-based matched case-control study

Bricola, Solange Aparecida Petilo Carvalho; Paiva, Edison F.; Lichtenstein, A.; Gianini, Reinaldo José; Duarte, Jurandir Godoy; Shinjo, Samuel Katsuyuki; Eluf-Neto, José; Martins, Mílton A.

doi:10.6061/clinics/2013(05)16

Cited by 9 publications

(5 citation statements)

References 32 publications

(40 reference statements)

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“…Corresponding rates of pulmonary embolism (PE) were 14% and 0.7%, respectively. In line with data from Africa and Asia, an analysis of more than 13 000 autopsies in a Brazilian hospital, PEs were noted in 3.8% of cases 16 . Taken together, these cross‐sectional data highlight differences in VTE rates among White Caucasians, Black Africans, East Asians, and Latin Americans across different continents.…”

Section: Epidemiology Of Vte Across Ethnoracial Groupssupporting

confidence: 80%

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Ethnoracial variations in venous thrombosis: Implications for management, and a call to action

Siegal

Anand

2021

Journal of Thrombosis and Haemostasis

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Despite decades of improvement in its diagnosis and management, venous thromboembolism (VTE) remains a significant cause of cardiovascular morbidity and mortality. Clinically relevant differences exist in the risk of symptomatic VTE among ethnoracial groups. Underlying these differences in rates of VTE are patterns of known genetic thrombophilias, which may also influence the risks of major bleeding related to vitamin K antagonists or direct oral anticoagulants. In addition, social factors, differential access to care, and disease awareness differ between ethnoracial groups, which contributes to disparities in VTE outcomes that include higher fatal events. The vast majority of participants included in clinical trials for the prevention and treatment of VTE have been White Caucasian, which limits our understanding of the differential impact of these agents in non‐White ethnoracial groups. Increasing the participation in clinical trials of diverse ethnoracial groups should be a priority, especially those groups who are disproportionately affected by the burden of VTE, or possible bleeding complications when exposed to anticoagulants. Advocacy by patients, researchers, and regulatory bodies is crucial to ensure adequate enrolment of diverse ethnoracial groups in order to best inform clinical decisions to optimize VTE prevention and treatment for non‐White populations.

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Section: Epidemiology Of Vte Across Ethnoracial Groupssupporting

confidence: 80%

“…In line with data from Africa and Asia, an analysis of more than 13 000 autopsies in a Brazilian hospital, PEs were noted in 3.8% of cases. 16 Taken together, these cross-sectional data highlight differences in VTE rates among White Caucasians, Black Africans, East…”

Section: Autopsy Studiesmentioning

confidence: 77%

Ethnoracial variations in venous thrombosis: Implications for management, and a call to action

Siegal

Anand

2021

Journal of Thrombosis and Haemostasis

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“…Следует отметить, что пациенты терапевтического профиля имели более высокий процент противопоказаний к лекарственной профилактикев сравнениис пациентамихирургического профиля (13% против 6,8%; p < 0,001 [20,[24][25][26].Установлено, что госпитализированные больные терапевтического профиля сталкиваются с двойной проблемой, с одной стороны, с высоким риском ВТЭв результатеналичияу пациентовбольшого количества ФР, с другой стороны, отсутствием должного уровня проводимой профилактики [25]. Имеются результаты нескольких исследований,свидетельствующихо том,что в более 70% случаев ВТЭ убивает терапевтических пациентовв результатеТЭЛА [27][28][29]. Данное исследование является первым региональным исследованием, посвященным проблеме оценки риска ВТЭ у госпитализированных пациентов и уровню надлежащей профилактики венозных тромбозов в специально отобранных больницах Казахстана.…”

Section: вопросы безопасности профилактики венозной тромбоэмболииunclassified

Risk assessment and prevention of venous thromboembolism among hospitalized patients: Results of the regional multicenter study

et al. 2021

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Introduction. Venous thromboembolism (VTE) is a major public health issue that is frequently underestimated. The primary objective of this multicenter study was to identify patients at risk for VTE, and to define the rate of patients receiving appropriate prophylaxis in the regions of Kazakhstan.Materials and methods. Standardized case report forms were filled by trained medical doctors on one predefined day in selected hospitals. Data were analyzed by independent biostatistician. Risk of VTE was categorized according to Caprini score which was recommended by 2004 American College of Chest Physicians (ACCP) guidelines.Results. 432 patients from 4 regions of Kazakhstan; 169 (39.10%) medical patients and 263 (60.9%) surgical patients were eligible for the study. Patients were at low (10%), moderate (19.2%), high (33.6%) and very high risk (37.3%) for VTE. The main risk factors (RF) of VTE among hospitalized patients were heart failure (HF), obesity, prolonged bed rest, and the presence of acute non-infective inflammation. From total number of hospitalized patients with RF with indications to VTE prophylaxis, 58.1% of patients received pharmacological prophylaxis and only 24.6% of them received VTE prophylaxis according ACCP. On the other hand, 23.5% patients with the risk of VTE but who were not eligible for it received pharmacological prophylaxis.Conclusion. These results indicate the existence of inconsistency between eligibility for VTE prophylaxis on one hand and its application in practice (p < 0.001). Risk factors for VTE and eligibility for VTE prophylaxis are common, but VTE prophylaxis and guidelines application are low.

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“…Percentage of correct diagnosis during the lifetime is approximately 30% (10-65%). 3 Untreated PE is associated with a high mortality rate ranging up to 30%, while the mortality in diagnosed and treated PE is 8%. About 10% of patients with PE die of sudden death.…”

Section: Introductionmentioning

confidence: 99%

Wells’ Score in Diagnosis of Pulmonary Embolism in Patient with Thrombocytopenia: A Case Report

Panic¹,

Todorovic²,

Stanojević³

et al. 2019

Serbian Journal of Experimental and Clinical Research

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Current diagnostic workup of patients with suspected acute pulmonary embolism (PE) usually starts with the assessment of clinical pretest probability, using clinical prediction rules and plasma D-dimer measurement. Although an accurate diagnosis of acute pulmonary embolism (PE) in patients is thus of crucial importance, the diagnostic management of suspected PE is still challenging. A 60-year-old man with chest pain and expectoration of blood was admitted to the Department of Cardiology, General Hospital in Cuprija, Serbia. After physical examination and laboratory analyses, the diagnosis of Right side pleuropne monia and acute pulmonary embolism was established. Clinically, patient was hemodynamically stable, auscultative slightly weaker respiratory sound right basal, without pretibial edema. Laboratory: C-reactive protein (CRP) 132.9 mg/L, Leukocytes (Le) 18.9x109/L, Erythrocytes (Er) 3.23x1012/L, Haemoglobin (Hgb) 113 g/L, Platelets (Plt) 79x109/L, D-dimer 35.2. On the third day after admission, D-dimer was increased and platelet count was decreased (Plt up to 62x109/L). According to Wells’ rules, score was 2.5 (without symptoms on admission), a normal clinical finding with clinical manifestation of hemoptysis and chest pain, which represents the intermediate level of clinical probability of PE. After the recidive of PE, Wells’ score was 6.5. In summary, this study suggests that Wells’ score, based on a patient’s risk for pulmonary embolism, is a valuable guidance for decision-making in combination with knowledge and experience of clinicians. Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being consiered.

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Fatal pulmonary embolism in hospitalized patients: a large autopsy-based matched case-control study

Cited by 9 publications

References 32 publications

Ethnoracial variations in venous thrombosis: Implications for management, and a call to action

Ethnoracial variations in venous thrombosis: Implications for management, and a call to action

Risk assessment and prevention of venous thromboembolism among hospitalized patients: Results of the regional multicenter study

Wells’ Score in Diagnosis of Pulmonary Embolism in Patient with Thrombocytopenia: A Case Report

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