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- W2158343129 abstract "Pulmonary embolism (PE) is a common disease with variable symptoms and high overall mortality. The clinical relevance of the extent of PE is still debatable, and the role of anticoagulation in patients with subsegmental involvement has been contested. Our objective is to describe the clinical details of patients with PE in our hospital and to analyze their prognosis based on the extent of the disease. Retrospective study of 313 patients diagnosed with PE by chest computed tomography (CT) scan at the Hospital Complex of Pontevedra in Spain for six years. Predictors of mortality were determined by multivariate analysis. Women accounted for 56% of patients, and patient median age was 70 years (interquartile range 53–78 years). Subsegmental PE accounted for 7% of all cases; these patients were younger and had lower comorbidity; they reported chest pain more often, performed better in blood gas analysis and none of them had proximal deep vein thrombosis (DVT). Patients with subsegmental PE had a higher survival rate. Factors independently associated with mortality were cancer diagnosis and higher comorbidity. Patients with subsegmental PE clinically differ from those with more proximal PE. Underlying diseases have more influence on the prognosis than the extent of the disease. A embolia pulmonar (PE) é uma doença comum com sintomas variáveis e uma elevada taxa de mortalidade global. A relevância clínica da extensão da PE é ainda fonte de debate, e o papel da anticoagulação em pacientes com envolvimento de sub-segmentos foi contestado. O nosso objectivo é descrever os dados clínicos de doentes com PE no nosso hospital e analisar o seu prognóstico, com base na extensão da doença. Estudo retrospectivo de 313 doentes, diagnosticados com PE, através de uma tomografia computadorizada de tórax (TC) no Complexo Hospitalar de Pontevedra, em Espanha, durante seis anos. Os preditores de mortalidade foram determinados por análise multivariada. As mulheres representaram 56% dos doentes, e a idade média era de 70 anos (amplitude interquartis 53–78 anos). A PE ao nível dos sub-segmentos era responsável por 7% de todos os casos; estes doentes eram mais jovens e tinham uma taxa de comorbidade inferior; referiram dor torácica com maior frequência, tiveram melhores resultados na gasimetria arterial e nenhum deles sofreu uma trombose venosa profunda (TVP) proximal. Os doentes com PE ao nível dos sub-segmentos tiveram uma taxa de sobrevivência mais elevada. Os factores associados de modo independente com a mortalidade foram o diagnóstico de cancro e uma comorbidade mais elevada. Os doentes com PE ao nível dos sub-segmentos diferem clinicamente daqueles com PE proximal. No prognóstico, as doenças subjacentes têm maior influência que a extensão da doença." @default.
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- W2158343129 date "2014-07-01" @default.
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- W2158343129 title "Symptoms, location and prognosis of pulmonary embolism" @default.
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- W2158343129 doi "https://doi.org/10.1016/j.rppneu.2013.09.006" @default.
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