Value of syncope in patients with high-to-intermediate risk pulmonary artery embolism

Duplyakov, D. V.; Kurakina, E A; Павлова, Т. В.; Хохлунов, С. М.; Суркова, Елена

doi:10.1177/2048872614527837

Cited by 30 publications

(37 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study showed statistically significant differences between clinical features of "massive" aPE compared with the "non-massive" PE group. Some symptoms such as syncope, dyspnea, weakness, chest pain, cough, fever, or hemopthysis can occur in both groups, but some of them are detected more often when emboli have obstructed the pulmonary trunk or its main branches (8). We noticed that syncope, dyspnea, and weakness more often occurred in the "massive" PE group whereas cough, chest pain and fever in the "non-massive" group.…”

Section: Discussionmentioning

confidence: 64%

“…In addition, near 40% of cases of aPE and DVT are prone to recur (4,7). The prognosis for aPE depends on many factors, such as individual response, the size and location of the clot, and comorbidities (8). Traditionally, massiveness of aPE has been defined on the basis of angiographic burden of emboli by use of the radiologic indexes designed for PE severity, such as Qanadli, Miller, or Mastora score (9,10).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic value of Mastora obstruction score in acute pulmonary embolism

Rackauskiene

Gedvilaite

Matačiūnas

et al. 2020

AML

View full text Add to dashboard Cite

Background. To evaluate the clinical significance of Mastora obstruction score in hemodynamically stable patients with acute pulmonary embolism (aPE). Materials and methods. One-hundred-and-six patients with newly diagnosed aPE, confirmed by computed tomography pulmonary angiography (CTPA), were included in the study and prospectively examined. aPE severity was assessed by using Mastora obstruction score. According to the Mastora index, patients were divided into “non-massive” and “massive” groups. The patients’ medical histories and blood laboratory data were collected, and instrumental tests were performed and analyzed. Results. Eighty-two (77%) of the patients had “non-massive” aPE. Cough (48%), fever (44%), and pleural effusion (48%) occurred significantly more often in the “non-massive” PE group, while syncope (42%) and right ventricular dysfunction (86%) were more frequent in the “massive” PE group. The probability of the right ventricular dysfunction was significantly higher in the presence of increased pulmonary artery pressure (Cramer’s V = 0.410; p < 0.0001) and respiratory failure (Cramer’s V = 0.247; p = 0.032). Increased CRP level was found in the majority of the patients (90%). D-dimer level

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Prognostic value of Mastora obstruction score in acute pulmonary embolism

Rackauskiene

Gedvilaite

Matačiūnas

et al. 2020

AML

View full text Add to dashboard Cite

show abstract

“…However, thrombolytic use was much lower in the scale of all patients with 5.6%. Duplyakov et al pointed out that thrombolytic therapy was used in 21 (60%) of 35 patients. Although syncope is not a criterion for thrombolytic therapy alone, aggressive therapy suggests a group of patients to be considered.…”

Section: Discussionmentioning

confidence: 99%

“…Duplyakov et al reported 23.8% of patients (19/80) those who classified in intermediate risk group according to ESC model (without a division into low‐risk or high‐risk) had syncope. Also, in this study, syncope rate was higher (29.9%) than that of the other studies.…”

Section: Discussionmentioning

confidence: 99%

Syncope as a subject of the risk assessment of pulmonary thromboembolism to be used for: A cross‐sectional study

Özyurt

Özsu

Erbay

et al. 2018

Clinical Respiratory J

View full text Add to dashboard Cite

show abstract

“…Their candidates for home care were low risk on the PE Severity Index and lacked the following contraindications, which parallel our own: hypoxemia, hypotension, active bleeding, high risk of bleeding, pregnancy, severe renal failure, barriers to adherence and follow up, and non-PE diagnoses requiring inpatient care. We drew from other studies of PE risk assessment and outpatient management to expand our list of relative contraindications to include right ventricular dysfunction (18,26,30,32,33) and syncope (20,41), two of the most common contraindications in our cohort.…”

Section: Original Researchmentioning

confidence: 99%

Impact of Relative Contraindications to Home Management in Emergency Department Patients with Low-Risk Pulmonary Embolism

et al. 2015

View full text Add to dashboard Cite

Rationale: Studies of adults presenting to the emergency department (ED) with acute pulmonary embolism (PE) suggest that those who are low risk on the PE Severity Index (classes I and II) can be managed safely without hospitalization. However, the impact of relative contraindications to home management on outcomes has not been described.Objectives: To compare 5-day and 30-day adverse event rates among low-risk ED patients with acute PE without and with outpatient ineligibility criteria. Methods:We conducted a retrospective multicenter cohort study of adults presenting to the ED with acute low-risk PE between 2010 and 2012. We evaluated the association between outpatient treatment eligibility criteria based on a comprehensive list of relative contraindications and 5-day adverse events and 30-day outcomes, including major hemorrhage, recurrent venous thromboembolism, and all-cause mortality.Measurements and Main Results: Of 423 adults with acute lowrisk PE, 271 (64.1%) had no relative contraindications to outpatient treatment (outpatient eligible), whereas 152 (35.9%) had at least one contraindication (outpatient ineligible). Relative contraindications were categorized as PE-related factors (n = 112; 26.5%), comorbid illness (n = 42; 9.9%), and psychosocial barriers (n = 19; 4.5%). There were no 5-day events in the outpatient-eligible group (95% upper confidence limit, 1.7%) and two events (1.3%; 95% confidence interval [CI], 0.1-5.0%) in the outpatient-ineligible group (P = 0.13). At 30 days, there were five events (two recurrent venous thromboemboli and three major bleeding events) in the outpatient-eligible group (1.8%; 95% CI, 0.7-4.4%) compared with nine in the ineligible group (5.9%; 95% CI, 2.7-10.9%; P , 0.05). This difference remained significant when controlling for PE severity class.Conclusions: Nearly two-thirds of adults presenting to the ED with low-risk PE were potentially eligible for outpatient therapy. Relative contraindications to outpatient management were associated with an increased frequency of adverse events at 30 days among adults with low-risk PE.

show abstract

Value of syncope in patients with high-to-intermediate risk pulmonary artery embolism

Cited by 30 publications

References 29 publications

Prognostic value of Mastora obstruction score in acute pulmonary embolism

Prognostic value of Mastora obstruction score in acute pulmonary embolism

Syncope as a subject of the risk assessment of pulmonary thromboembolism to be used for: A cross‐sectional study

Impact of Relative Contraindications to Home Management in Emergency Department Patients with Low-Risk Pulmonary Embolism

Contact Info

Product

Resources

About