Syncope in Non-Massive Pulmonary Embolism as a Predictor of High-Risk Mortality

Kurakina, E A; Duplyakov, D. V.; Хохлунов, С. М.; Kozupitsa, G. S.

doi:10.20996/1819-6446-2012-8-2-158-162

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…All cases of in-hospital mortality were related to patients with massive PTE. This difference was statistically significant and indicated the association between the severity of the disease and in-hospital mortality, which is similar to other study findings (28,29). In addition, there were no significant differences in acute complications between three groups of age.…”

Section: Discussionsupporting

confidence: 90%

Acute Pulmonary Embolism and 1-Year Outcome: An Epidemiological Study in East of Iran, 2011-2016

2019

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Background: Pulmonary thromboembolism (PTE) is a major health problem worldwide. The present study was conducted to investigate epidemiology of acute PTE and its outcomes in Birjand city, locating in South Khorasan, Iran. Methods:In this descriptive epidemiological study, 79 patients with PTE referred to Vali-Asr Hospital, Birjand, Iran were studied during 2011 -2016. In this study, demographic data, medical history, risk factors, symptoms, and information on diagnostic methods including echocardiography findings, electrocardiographic findings, treatment procedure, duration of hospitalization, and therapeutic outcomes were collected in information form for each patient. One year later, the patients were re-visited, and echocardiography was performed for all the subjects. Finally, data were analyzed by Chi-Square and Fisher's exact tests at a significant level of 0.05 using SPSS software.Results: Results showed that annual incidence of PTE was 5.7 per 100,000 people in Birjand in 2016. History of recent surgery (18.8%) followed by hospitalization, and complete bed rest for more than 3 days (15.7%) were the most common risk factors. More than 78% of patients with PTE had abnormal echocardiography, and pulmonary arterial hypertension was the most common finding. Results of statistical analysis showed that complications were not statistically significant according to age and gender of patients (P < 0.05), but complications were higher in patients with massive PTE compared to others (P = 0.01). Comparison of in-hospital complications showed a significant difference between different treatment modalities (P < 0.01). Conclusions:History of recent surgery and hospitalization were the most common predisposing factors for PTE. Therefore, necessary programs should be more vigorously pursued for prevention of PTE.

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Section: Discussionsupporting

confidence: 90%

Acute Pulmonary Embolism and 1-Year Outcome: An Epidemiological Study in East of Iran, 2011-2016

2019

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Antithrombotic Therapy and the Nearest Forecast of Pulmonary Embolism in Rutine Clinical Practice (Data of the Regional Vascular Center of the Ryazan Region)

Никулина

Terekhovskaya

Yakushin

2022

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To perform the analysis of antithrombotic therapy and immediate prognosis in patients with pulmonary embolism (PE) in routine clinical practice.Materials and methods. During 13 months of follow-up (2018-2019) within the framework of the Russian SIRENA registry, the study included patients (n=103) with verified PE who were hospitalized at the regional vascular center. Main results. Thrombolytic therapy was performed in 63 patients (61.2% of the sample), of which 48 (76.2%) had no indications. In these cases, the most common reason for performance was the results of the PESI score (n=17) and/or a significant amount of damage to the pulmonary artery (n=10) and/or severe shortness of breath (n=3) and/or the presence of a thrombus in the right parts of the heart or deep veins of the lower extremities (n=2), in addition, in a number of medical records, the cause is indicated as “for health reasons” (n=6) or there were no data (n=10). Patients who underwent thrombolysis had a larger volume of pulmonary lesions, more pronounced signs of respiratory failure and overload of the right heart, as well as a shorter duration of clinical manifestations. Anticoagulant therapy was used in 94.2% of cases, of which 90.3% of patients used parenteral forms at the start, then direct oral anticoagulants were mainly used, the frequency of warfarin prescription was only 5.8% of cases. Bleeding was registered in 19.4% of patients (significant – in 11.7%). PE recurrence after diagnosis and initiation of therapy was observed in 4 cases (3.9%). Hospital mortality was 9.7%. Predictors of poor prognosis were hospitalization with a different diagnosis (risk ratio [RR] 16.2; p=0.001), advanced age (RR 10.1; p=0.028), unstable hemodynamics (RR 7.6; p=0.002), chronic kidney disease C3- 5 (RR 5.6; p=0.03), history of stroke (RR 5.3; p=0.016) and chronic heart failure (RR 3.9; p=0.035).Conclusion. In modern clinical practice, the indications for thrombolysis often differ from those recommended, which leads to an increase in the number of bleeding and leveling of the positive effect on the prognosis. Factors such as advanced age, chronic heart failure and atrial fibrillation, stroke, chronic kidney disease, hemodynamic instability, hospitalizations with a different primary diagnosis, and the need for oxygen therapy increase the risk of early mortality.

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Difficulties and Peculiarities of Early Diagnostics of Pulmonary Embolism

et al. 2018

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The retrospective analysis of 22 patients’ clinical records with the verified pulmonary artery thromboembolism (PE) with various outcomes of a disease is carried out. Hypodiagnostics of PE at a pre-hospital stage is revealed, the predictive importance of Revised Geneva Score scale is shown, predictors of a lethal outcome at a PE are defined: arterial hypotension, tachycardia, McGinn-White syndrome (SI-QIII phenomenon).

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Syncope in Non-Massive Pulmonary Embolism as a Predictor of High-Risk Mortality

Cited by 3 publications

References 19 publications

Acute Pulmonary Embolism and 1-Year Outcome: An Epidemiological Study in East of Iran, 2011-2016

Acute Pulmonary Embolism and 1-Year Outcome: An Epidemiological Study in East of Iran, 2011-2016

Antithrombotic Therapy and the Nearest Forecast of Pulmonary Embolism in Rutine Clinical Practice (Data of the Regional Vascular Center of the Ryazan Region)

Difficulties and Peculiarities of Early Diagnostics of Pulmonary Embolism

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