Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

Abstract

Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%; p < 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%; p = 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n = 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50–1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96–463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01–0.98) were found as independent predictors of mortality. Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients.

MELD-Albumin score predicts 30-day mortality in high-risk patients with acute pulmonary embolism admitted to intensive care units

“…Our ndings are consistent with those of Cugno et al [41,42] and Agrawal et al [41,42]. The rate of thrombolytic therapy was high in our study compared with that reported in previous studies [43,44]. This difference may be explained by the low rate of conditions that contraindicate thrombolytic treatment, including cancer, surgery, and pregnancy in our study or by the high rate of high-risk patients in our cohort.…”

Pulmonary embolism in intensive care units: More frequent or more Known? Prospective study of 75 cases

“…Our findings confirm that subjects in the ICU are at high risk for both DVT and PE, due to the high number of risk‐factors. Moreover, our study confirms the results of a few studies recently published, showing a high incidence of PE (ranging from 6 to 20%) in patients requiring ICU admission, despite prophylactic measures …”

“…Moreover, our study confirms the results of a few studies recently published, showing a high incidence of PE (ranging from 6 to 20%) in patients requiring ICU admission, despite prophylactic measures. [1][2][3][4][5]17,18 In addition, we have established-in the current studythat PE is associated with poor outcome. In fact, the development of this complication is associated with a high mortality rate, a high rate of nosocomial infections, and a prolonged ICU and in-hospital length of stay (LOS).…”

Correlations of inhaled NO with the cTnI levels and the plasma clotting factor in rabbits with acute massive pulmonary embolism

“…The mortality rate of acute massive pulmonary thromboembolism was about 30% [3][4] , which was very high 1,2 , particularly in patients with shock or heart failure,, so the risk of mortality should be assessed as early as possible to maintain more effective treatments [5][6][7] . The European Society of Cardiology has divided the prognostic risk into 3 levels.…”