Read by QxMD icon Read


David R Vinson, Dustin W Ballard, Dustin G Mark, Jie Huang, Mary E Reed, Adina S Rauchwerger, David H Wang, James S Lin, Mamata V Kene, Tamara S Pleshakov, Dana K Sax, Jordan M Sax, D Ian McLachlan, Cyrus K Yamin, Clifford J Swap, Hilary R Iskin, Ridhima Vemula, Bethany S Fleming, Andrew R Elms, Drahomir Aujesky
INTRODUCTION: The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score to estimate the 30-day mortality of emergency department (ED) patients with acute pulmonary embolism (PE). A simplified version (sPESI) was derived but has not been as well studied in the U.S. We sought to validate both indices in a community hospital setting in the U.S. and compare their performance in predicting 30-day all-cause mortality and classification of cases into low-risk and higher-risk categories...
September 24, 2016: Thrombosis Research
Evangelos Giannitsis, Hugo A Katus
BACKGROUND: Pulmonary embolism (PE) is associated with high all-cause and PE-related mortality and requires individualized management. After confirmation of PE, a refined risk stratification is particularly warranted among normotensive patients. Previous prognostic models favored combinations of echocardiography or computed tomography suggestive of right ventricular (RV) dysfunction together with biomarkers of RV dysfunction (natriuretic peptides) or myocardial injury (cardiac troponins) to identify candidates for thrombolysis or embolectomy...
October 19, 2016: Clinical Chemistry
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients. METHODS: We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006-2010 including all adult patients with a primary diagnosis of DVT or PE...
September 2016: Clin Exp Emerg Med
Anthony J Weekes, Angela K Johnson, Daniel Troha, Gregory Thacker, Jordan Chanler-Berat, Michael Runyon
BACKGROUND: Right ventricular dysfunction (RVD) in pulmonary embolism (PE) has been associated with increased morbidity. Tools for RVD identification are not well defined. The prognostic value of RVD markers to predict serious adverse events (SAE) during hospitalization is unclear. OBJECTIVE: Prospectively compare the incidence of SAE in normotensive emergency department patients with PE based upon RVD by goal-directed echocardiography (GDE), cardiac biomarkers, and right-to-left ventricle ratio by computed tomography (CT)...
October 14, 2016: Journal of Emergency Medicine
Selçuk Yazıcı, Tuncay Kırış, Ufuk S Ceylan, Şükrü Akyüz, Ahmet O Uzun, Recep Hacı, Sait Terzi, Abdullah Doğan, Ayşe Emre, Kemal Yeşilçimen
BACKGROUND: Cardiac troponins and red cell distribution width (RDW) are associated with increased mortality in acute pulmonary embolism (PE). In this study, we aimed to investigate the accuracy of the combined use of troponin and RDW in predicting short-term mortality in acute PE patients. METHODS: The data of 201 patients with the diagnosis of acute PE were retrospectively analyzed. We obtained troponin-RDW scores (TR scores) using a combination of troponin and RDW values, and then evaluated this score's accuracy in predicting mortality in patients with acute PE...
September 19, 2016: Wiener Klinische Wochenschrift
Erin R Weeda, Christine G Kohn, W Frank Peacock, Gregory J Fermann, Concetta Crivera, Jeff R Schein, Craig I Coleman
STUDY OBJECTIVE: To compare hospital length of stay (LOS) and hospital treatment costs in low-risk patients with pulmonary embolism (PE) anticoagulated with rivaroxaban or heparin bridging to warfarin therapy. DESIGN: Retrospective review of electronic health records and hospital billing records. SETTING: Large, teaching hospital in the northeastern United States. PATIENTS: One hundred ninety adults with objectively confirmed acute PE presenting to the emergency department between November 1, 2012, and May, 12, 2015, who were classified as low risk of early mortality and received anticoagulation with either rivaroxaban or heparin (i...
October 2016: Pharmacotherapy
Hernan Polo Friz, Chiara Buzzini, Annalisa Orenti, Veronica Punzi, Mauro Molteni, Laura Primitz, Luca Cavalieri d'Oro, Guido Arpaia, Patrizia Boracchi, Claudio Cimminiello
In a general population with acute Pulmonary Embolism (PE) elevated D-dimer concentrations associate with increased mortality. The aim of the study was to assess the ability of D-dimer to predict 30 and 90-days mortality in elderly patients with acute PE. Hemodynamically stable patients aged ≥65 years old with confirmed PE were included in this retrospective cohort study. A pulmonary computerized tomography angiography scan, D-dimer concentrations, simplified Pulmonary Embolism Severity Index (sPESI) variables and vital status were available for all patients...
October 2016: Journal of Thrombosis and Thrombolysis
A Carmona-Bayonas, C Font, P Jiménez-Fonseca, Francisco Fenoy, R Otero, C Beato, J Plasencia, M Biosca, M Sánchez, M Benegas, D Calvo-Temprano, D Varona, L Faez, M A Vicente, I de la Haba, M Antonio, O Madridano, A Ramchandani, E Castañón, P J Marchena, M J Martínez, M Martín, G Marín, F Ayala de la Peña, V Vicente
BACKGROUND: Acute symptomatic pulmonary embolism (PE) varies in its clinical manifestations in patients with cancer and entails specific issues. The objective is to assess the performance of five scores (PESI, sPESI, GPS, POMPE, and RIETE) and a clinical decision rule to predict 30-day mortality. METHODS: This is an ambispective, observational, multicenter study that collected episodes of PE in patients with cancer from 13 Spanish centers. The main criterion for comparing scales was the c-indices and 95% confidence intervals (CIs) of the models for predicting 30-day mortality...
July 2016: Thrombosis Research
Cecilia Becattini, Giancarlo Agnelli, Mareike Lankeit, Luca Masotti, Piotr Pruszczyk, Franco Casazza, Simone Vanni, Cinzia Nitti, Pieter Kamphuisen, Maria Cristina Vedovati, Maria Grazia De Natale, Stavros Konstantinides
The European Society of Cardiology (ESC) has proposed an updated risk stratification model for death in patients with acute pulmonary embolism based on clinical scores (Pulmonary Embolism Severity Index (PESI) or simplified PESI (sPESI)), right ventricle dysfunction (RVD) and elevated serum troponin (2014 ESC model).We assessed the ability of the 2014 ESC model to predict 30-day death after acute pulmonary embolism. Consecutive patients with symptomatic, confirmed pulmonary embolism included in prospective cohorts were merged in a collaborative database...
September 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Antoine Elias, Susan Mallett, Marie Daoud-Elias, Jean-Noël Poggi, Mike Clarke
OBJECTIVE: To review the evidence for existing prognostic models in acute pulmonary embolism (PE) and determine how valid and useful they are for predicting patient outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: OVID MEDLINE and EMBASE, and The Cochrane Library from inception to July 2014, and sources of grey literature. ELIGIBILITY CRITERIA: Studies aiming at constructing, validating, updating or studying the impact of prognostic models to predict all-cause death, PE-related death or venous thromboembolic events up to a 3-month follow-up in patients with an acute symptomatic PE...
2016: BMJ Open
C L Shi, H X Zhou, Y J Tang, L Wang, Q Yi, Z A Liang
OBJECTIVE: To explore the risk factors of venous thromboembolism (VTE) recurrence and the predictive value of simplified pulmonary embolism severity index (sPESI) in medical inpatients. METHODS: A total of 149 consecutive patients with first diagnosed VTE from the medical departments of West China Hospital of Sichuan University from January 2011 and December 2012 were enrolled and followed-up for 24 months. The VTE recurrence rate was calculated and univariate and multivariate cox proportional hazards regression analysis were performed to identify the risk factors associated with VTE recurrence...
April 12, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Erin R Weeda, Christine G Kohn, Gregory J Fermann, W Frank Peacock, Christopher Tanner, Daniel McGrath, Concetta Crivera, Jeff R Schein, Craig I Coleman
BACKGROUND: Studies show the In-hospital Mortality for Pulmonary embolism using Claims daTa (IMPACT) rule can accurately identify pulmonary embolism (PE) patients at low-risk of early mortality in a retrospective setting using only claims for the index admission. We sought to externally validate IMPACT, Pulmonary Embolism Severity Index (PESI), simplified PESI (sPESI) and Hestia for predicting early mortality. METHODS: We identified consecutive adults admitted for objectively-confirmed PE between 10/21/2010 and 5/12/2015...
2016: Thrombosis Journal
Christopher C Y Wong, Austin C C Ng, Jerrett K Lau, Vincent Chow, Vivien Chen, Arnold C T Ng, Andy S C Yong, Andrew P Sindone, Thomas H Marwick, Leonard Kritharides
The prognostic significance of patients presenting with pulmonary embolism (PE) and elevated International Normalised Ratio (INR) not on anticoagulant therapy has not been described. We investigated whether these patients had higher mortality compared to patients with normal INR. A retrospective study of patients admitted to a tertiary hospital with acute PE from 2000 to 2012 was undertaken, with study outcomes tracked using a state-wide death registry. Patients were excluded if they were taking anticoagulants or had inadequate documentation of their INR and medication status...
June 2, 2016: Thrombosis and Haemostasis
J A Saar, C Maack
Acute pulmonary embolism (PE) still represents a challenge regarding a rapid diagnosis and a risk-adapted therapy. In the 2014 guidelines of the European Society of Cardiology (ESC) on the diagnosis and management of acute PE, several new recommendations have been issued based on new study data. Some established scores for risk stratification were developed further and there is now good evidence for the use of age-adjusted D-dimer cut-off levels. For the risk stratification in patients without clinical features of shock, the utilization of the pulmonary embolism severity index (PESI) and simplified PESI (sPESI) scores is recommended...
December 2015: Herz
Shuai Zhang, Zhenguo Zhai, Yuanhua Yang, Jianguo Zhu, Tuguang Kuang, Wanmu Xie, Suqiao Yang, Fangfang Liu, Juanni Gong, Ying H Shen, Chen Wang
Venous thromboembolism (VTE) recurrence carries significant mortality and morbidity. Accurate risk assessment and effective treatment for patients with acute pulmonary embolism (PE) is important for VTE recurrence prevention. We examined the association of VTE recurrence with risk stratification and PE treatment. We enrolled 627 patients with a first episode of confirmed PE. Baseline clinical information was collected. PE severity was assessed by the European Society of Cardiology's (ESC) risk stratification, the simplified PE Severity Index (sPESI) and the Qanadli score of clot burden...
January 1, 2016: International Journal of Cardiology
Lei Tian, William S Krimsky, Qingchen Wu, Jiayuan Sun
Mediastinal abscess is a fatal condition, treatment of mediastinal abscess is with antibiotics and sometimes surgery for debridement and drainage. We report a case of a 56-year-old man with developed bilateral pneumonia and spesis after puncture of mediastinal abscess by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), and successfully treated with a combination of systemic anti-infection treatment and intracavitary administration of antibiotics, antifungal and repeated drainage and lavage via EBUS-TBNA to avoid further surgical intervention...
August 10, 2015: Clinical Respiratory Journal
Luca Masotti, Grazia Panigada, Giancarlo Landini, Filippo Pieralli, Francesco Corradi, Salvatore Lenti, Rino Migliacci, Stefano Arrigucci, Anna Frullini, Maria Chiara Bertieri, Stefano Tatini, Alberto Fortini, Irene Cascinelli, Nicola Mumoli, Stefano Giuntoli, Alessandro De Palma, Veronica De Crescenzo, Michele Piacentini, Giancarlo Tintori, Alba Dainelli, Giuseppa Levantino, Plinio Fabiani, Filippo Risaliti, Roberta Mastriforti, Michele Voglino, Valentina Carli, Simone Meini
Prognostic stratification of acute pulmonary embolism (PE) remains a challenge in clinical practice. Simplified PESI (sPESI) score is a practical validated score aimed to stratify 30-day mortality risk in acute PE. Whether prognostic value of sPESI score differs according to sex has not been previously investigated. Therefore the aim of our study was to provide information about it. Data records of 452 patients, 180 males (39.8 %) and 272 females (60.2 %) discharged for acute PE from Internal Medicine wards of Tuscany (Italy) were analysed...
May 2016: Journal of Thrombosis and Thrombolysis
Ana Maestre, Javier Trujillo-Santos, Antoni Riera-Mestre, David Jiménez, Pierpaolo Di Micco, José Bascuñana, Jerónimo Ramón Vela, Luísa Peris, Pablo César Malfante, Manuel Monreal
RATIONALE: Patients with acute symptomatic pulmonary embolism (PE) deemed to be at low risk for early complications might be candidates for partial or complete outpatient treatment. OBJECTIVES: To develop and validate a clinical prediction rule that accurately identifies patients with PE and low risk of short-term complications and to compare its prognostic ability with two previously validated models (i.e., the Pulmonary Embolism Severity Index [PESI] and the Simplified PESI [sPESI]) METHODS: Multivariable logistic regression of a large international cohort of patients with PE prospectively enrolled in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry...
August 2015: Annals of the American Thoracic Society
Harun Kundi, Ahmet Balun, Hulya Cicekcioglu, Mustafa Cetin, Emrullah Kiziltunc, Zehra Guven Cetin, Candan Mansuroglu, Ender Ornek
PURPOSE: In this study, we aimed to investigate the value of the platelet-to-lymphocyte ratio (PLR) for predicting disease severity based on simplified Pulmonary Embolism Severity Index (sPESI), as well as in-hospital mortality in patients with acute pulmonary embolism (APE). MATERIALS AND METHODS: Our hospital's electronic patient database was searched for the patients with ICD-9 code I26, and eligible 646 patients were included in the study. RESULTS: Univariate logistic regression analysis showed that PLR, pulmonary artery systolic pressure, right ventricular dysfunction, D-dimer level, and white blood cell, lymphocyte, platelet and neutrophil counts were significantly correlated with a high sPESI score in patients with APE...
July 2015: Heart & Lung: the Journal of Critical Care
Savas Ozsu, Hayriye Bektas, Yasin Abul, Tevfik Ozlu, Asım Örem
BACKGROUND: Currently, guidelines do not recommend any standard approach for treatment of pulmonary thromboembolism (PTE) at outpatient setting. We investigated the efficacy and safety of a 90-day anticoagulant treatment of outpatients diagnosed with PTE who had negative troponin levels and low-risk simplified pulmonary embolism severity index (sPESI) at presentation. METHODS: This prospective cohort study included a total of 206 patients with objectively confirmed acute symptomatic PTE...
August 2015: Lung
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"