Value of Cardiac Troponin and sPESI in Treatment of Pulmonary Thromboembolism at Outpatient Setting

Özsu, Savaş; Bektas, Hayriye; Abul, Yasin; Özlü, Tevfik; Örem, Asım

doi:10.1007/s00408-015-9727-5

Cited by 11 publications

(3 citation statements)

References 18 publications

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“…In our study, the overall mortality rate was around 13%, and no change was observed in the mortality rate over the years. The mortality rate was found to be 13% in our two prospective studies between 2008 and 2009 and between 2012 and 2014 [5,6]. However, while the PTErelated mortality rate was 5.6% in our first study, it was 4.4% in the other one.…”

Section: Discussioncontrasting

confidence: 54%

Does the Incidence and Mortality of Pulmonary Thromboembolism Change Over the Years?

Özsu¹,

Durmuş²,

Coşkuner³

et al. 2017

Turk Thorac J

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OBJECTIVES:In the last 20 years, with the use of computed tomography (CT) angiography, the number of patients diagnosed with pulmonary thromboembolism (PTE) has increased. At the same time, data show that pulmonary embolism mortality has also reduced in this duration. MATERIAL AND METHODS:In this study, we analyzed records of patients with PTE (using ICD's) in the hospital automation system from 2001 to 2013. Data regarding age, sex, date of diagnosis, diagnosis of cancer, hemodynamic status, initial and maintenance treatment, hospital length of stay, and hospital mortality were recorded. Primary endpoints of the study were hospital length of stay and all-cause hospital mortality. RESULTS:The total number of patients included in the study was 1185. The median age was 61 years in 2001 and 71 years in 2013. The number of patients who were diagnosed using CT increased from 10% to 92.8%. Between 2001 and 2013, the number of patients diagnosed with PTE increased, and of all patients with PTE, 13.7% was diagnosed in 2009. The hospital length of stay of 13 days declined to 9 days. The use of a vena cava filter in 2007 was 1.1% and that in 2013 was 4.6%. Mortality rate was 15%, however hospital mortality did not significantly differ over the years but varied between 9.4% and 18.8%. Increased use of thrombolytics in patients with massive PTE has been observed over the years. Massive PTE ratio in 2006 was 8.5% and thrombolytic use was 5.8%, however in 2013, these ratios were 2.6%, 6% respectively (p=0.017). CONCLUSION:Finally, despite the increased number of patients diagnosed with PTE over the years, the mortality rate was not observed to have changed from 2001 to 2013. KEYWORDS:Pulmonary thromboembolism, heparin, thrombolytic, mortality, incidence INTRODUCTIONPulmonary thromboembolism (PTE) is an important public health concern that causes mortality and morbidity. Its non-specific symptoms and findings lead to difficulties in confirming its diagnosis. However, with the use of computed tomography (CT) angiography in recent years, an important step has been taken in the diagnosis of PTE. Moreover, improvements, such as the development of new anticoagulants and mechanical interventions, have occurred in the treatment of PTE. In parallel with all these improvements, data on the incidence and outcomes of the disease seems to be restricted.In a study conducted in USA the incidence of PTE was reported to increase from 23/100,000 to 65/100,000 [1]. On the other hand, in a study conducted in Canada, no significant change was observed in the incidence of PTE in the last decade [2]. A study was conducted on 60853 patients in Italy, and an increase was found in the incidence of PTE in the last 10 years [3]. In our study, the data of patients diagnosed with PTE between 2001 and 2013 were obtained from hospital recordings and were analyzed. MATERIAL AND METHODSIn our study, the records of patients diagnosed with PTE between 2001 and 2013 were obtained from the hospital's automations system (with the International Classification of Di...

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Section: Discussioncontrasting

confidence: 54%

Does the Incidence and Mortality of Pulmonary Thromboembolism Change Over the Years?

Özsu¹,

Durmuş²,

Coşkuner³

et al. 2017

Turk Thorac J

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“…Tolv studier oppfylte kriteriene (8,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). To var randomiserte kliniske studier (17,21), mens resten var observasjonsstudier.…”

Section: Resultaterunclassified

“…Det er også grunn til å tro at kriteriene kan utbedres. Eksempelvis har studier vist at nytteverdien til forenklet PESI (sPESI) kan forbedres ved å integrere målinger av serumtroponiner, serum-natrium og/eller serum-bikarbonat i nyere modeller (18,30,31). Dette indikerer rom for videre optimalisering, men siden funnene ikke er reprodusert i større kliniske studier, mangler de dokumentasjon for bruk i klinisk praksis.…”

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Hjemmebehandling ved lungeembolisme

Blomkvist¹,

Zadig²,

Christoffersen³

et al. 2019

Tidsskriftet

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Classification of high-risk with cardiac troponin and shock index in normotensive patients with pulmonary embolism

Özsu

Erbay

Durmuş

et al. 2016

J Thromb Thrombolysis

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Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission. The primary end-point occurred in 67 (13.7%, 95% CI 10.7-16.8) patients with acute PE. Predictors of complications included elevated cardiac troponin (OR 1.7, 95% CI 1.3-2.2) and shock index (OR 1.3, 95% CI 1.1-1.5) by multivariable analysis. Risk index point was created based on OR. The model identified stages (stage I: 0-1 point, stage II: 2 points and stage III: 3 point) with 30-day mortality rates of 4.3, 19 and 38.6 %, respectively. The shock index and cardiac troponin can be safely used in combination to determine intermediate risk in patients with PE in emergency departmant. The study provided observations that will require prospective validation before the proposed risk score is adopted in clinical practice.

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Value of Cardiac Troponin and sPESI in Treatment of Pulmonary Thromboembolism at Outpatient Setting

Abstract: We observed that patients with acute PTE, low-risk sPESI, and negative troponin levels can be safely treated in the outpatient settings. Also the presence of cancer alone does not necessitate hospitalization.

Cited by 11 publications

References 18 publications

Does the Incidence and Mortality of Pulmonary Thromboembolism Change Over the Years?

Does the Incidence and Mortality of Pulmonary Thromboembolism Change Over the Years?

Hjemmebehandling ved lungeembolisme

Classification of high-risk with cardiac troponin and shock index in normotensive patients with pulmonary embolism

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