Prognostic Significance of Deep Vein Thrombosis in Patients Presenting with Acute Symptomatic Pulmonary Embolism

Abstract

In patients with a first episode of acute symptomatic PE, the presence of concomitant DVT is an independent predictor of death in the ensuing 3 months after diagnosis. Assessment of the thrombotic burden should assist with risk stratification of patients with acute PE.

Risk Stratification of Patients With Acute Symptomatic Pulmonary Embolism Based on Presence or Absence of Lower Extremity DVT

“…A study of patients with a first, objectively confirmed episode of acute symptomatic PE supported the hypothesis that increased thrombus burden has a poor prognosis by demonstrating that those with evidence of concomitant DVT had, compared to those without DVT, an increased risk of all-cause death, PE-related death, and recurrent VTE over 3-months of follow-up (12). However, other studies have shown conflicting data regarding the association between concomitant DVT at the time of PE diagnosis and VTE event rates (13)(14)(15).…”

“…Of the 165 articles screened, 9 appeared potentially eligible and underwent an in depth review (12,15,(22)(23)(24)(25)(26)(27)(28). Four of the 9 studies were deemed ineligible (22)(23)(24)(25).…”

“…Four of the 9 studies were deemed ineligible (22)(23)(24)(25). Hand searching found 5 additional studies (3,13,(29)(30)(31), therefore 10 studies met the eligibility criteria (3,12,13,15,(26)(27)(28)(29)(30)(31) (Figure 1). For 3 of these DVT and PE prognosis: systematic review 8 studies (27,28,30), the numbers of patients who experienced an adverse outcome event were obtained by contacting the authors.…”

Pulmonary embolism: clinical guidelines of European Society of Cardiology (2014).The Task Force of the European Society of Cardiology for diagnosis and management of pulmonary embolism

“…Диагноз сопутствующего ТГВ также расце нивается как самостоятельный фактор прогноза ле тального исхода в первые 3 мес. после диагностики ТЭЛА [210].…”

Factores pronósticos y estratificación del riesgo en pacientes con tromboembolia de pulmón aguda sintomática

“…Jiménez et al estudiaron 707 pacientes con un primer episodio de TEP a los que realizaron ecografía completa de miembros inferiores en las 48 horas posteriores al diagnóstico de TEP 7 . Los autores encontraron que los pacientes con TEP y trombosis venosa profunda (TVP) presentaron un riesgo significativamente mayor de recurrencia tromboembólica, muerte por cualquier causa y muerte por TEP que los pacientes sin TVP.…”