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https://www.readbyqxmd.com/read/29778034/early-discharge-of-patients-with-pulmonary-embolism-in-daily-clinical-practice-a-prospective-observational-study-comparing-clinical-gestalt-and-clinical-rules
#1
Simone Vanni, Cecilia Becattini, Peiman Nazerian, Carlo Bova, Valerio Teodoro Stefanone, Ludovica Anna Cimini, Gabriele Viviani, Cosimo Caviglioli, Michela Sanna, Giuseppe Pepe, Stefano Grifoni
OBJECTIVES: To estimate the efficiency and safety of clinicians' gestalt in the identification of patients with pulmonary embolism (PE) candidates for early discharge and to compare the efficiency and safety of clinical gestalt with that of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI) and the Hestia criteria (HC). METHODS: Consecutive adult patients presenting to the emergency department of four Italian hospitals with confirmed diagnosis of PE were included...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29733493/prediction-of-short-term-prognosis-in-elderly-patients-with-acute-pulmonary-embolism-validation-of-the-riete-score
#2
E Jaquet, T Tritschler, O Stalder, A Limacher, M Méan, N Rodondi, D Aujesky
INTRODUCTION: The RIETE score was derived to identify patients with pulmonary embolism (PE) at low risk of overall complications. OBJECTIVE: To externally validated the RIETE score and compared its prognostic performance to the Pulmonary Embolism Severity Index (PESI), its simplified version (sPESI), and the Geneva Prognostic Score (GPS). METHODS: In a prospective multicenter cohort, we studied 687 elderly patients with acute PE. The primary outcome was 10-day overall complications (death, recurrent PE, or major bleeding), the secondary outcome was 30-day overall mortality...
May 7, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29276010/clinical-gestalt-versus-prognostic-scores-for-prognostication-of-patients-with-acute-symptomatic-pulmonary-embolism
#3
Carlos Andrés Quezada, Celia Zamarro, Vicente Gómez, Ina Guerassimova, Rosa Nieto, Esther Barbero, Diana Chiluiza, Deisy Barrios, Raquel Morillo, David Jiménez
BACKGROUND AND OBJECTIVE: To determine the accuracy of clinical gestalt to identify patients with acute symptomatic pulmonary embolism (PE) at low-risk for short-term complications. PATIENTS AND METHODS: This study included a total of 154 consecutive patients diagnosed with acute symptomatic PE in a tertiary university hospital. We compared the prognostic accuracy of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI), and clinical gestalt of 1) 2senior physicians (one with and one without experience in the management of patients with PE), 2) a fourth-year resident of Pneumology, 3) a third-year resident of Pneumology, and 4) a second-year resident of Pneumology...
December 21, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29242264/prognostic-value-of-right-ventricular-dilatation-in-patients-with-low-risk-pulmonary-embolism
#4
Benoit Côté, David Jiménez, Benjamin Planquette, Anne Roche, Jonathan Marey, Jean Pastré, Guy Meyer, Olivier Sanchez
The prognosis of multidetector computed tomography (MDCT) assessed right ventricular dilatation (RVD) is unclear in patients with pulmonary embolism (PE) and a simplified Pulmonary Embolism Severity Index (sPESI) of 0. We investigated in these patients whether MDCT-assessed RVD, defined by a right to left ventricular ratio (RV/LV) ≥0.9 or ≥1.0, is associated with worse outcomes.We combined data from three prospective cohorts of patients with PE. The main study outcome was the composite of 30-day all-cause mortality, haemodynamic collapse or recurrent PE in patients with sPESI of 0...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29226891/the-relationship-between-right-ventricular-outflow-tract-fractional-shortening-and-pulmonary-embolism-severity-index-in-acute-pulmonary-embolism
#5
Ekrem Şahan, Murat Karamanlıoğlu, Suzan Şahan, Murat Gül, Ahmet Korkmaz, Omaç Tüfekçioğlu
OBJECTIVE: Right ventricular (RV) functions are clinically important in acute pulmonary embolism (APE). Measurement of systolic function of the right ventricular outflow tract (RVOT) with echocardiography is a simple method to evaluate RV function. The aim of this study was to determine the relationship between RVOT systolic function and the Pulmonary Embolism Severity Index (PESI). METHODS: A total of 151 patients diagnosed with APE by pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were included...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28890217/saddle-vs-nonsaddle-pulmonary-embolism-clinical-presentation-hemodynamics-management-and-outcomes
#6
Bashar Alkinj, Bibek S Pannu, Dinesh R Apala, Aditya Kotecha, Rahul Kashyap, Vivek N Iyer
OBJECTIVE: To understand the clinical significance, hemodynamic presentation, management, and outcomes of patients presenting with saddle pulmonary embolism (PE). METHODS: All patients with saddle PE diagnosed at Mayo Clinic in Rochester, Minnesota, from January 1, 1999, through December 31, 2014, were included in this study. These patients were age and simplified Pulmonary Embolism Severity Index (sPESI) matched (1:1) to a nonsaddle PE cohort. Both groups were then classified into massive, submassive, and low-risk PE based on established criteria and compared for clinical presentation, management, and outcomes...
October 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28852931/comorbidity-assessment-as-predictor-of-short-and-long-term-mortality-in-elderly-patients-with-hemodynamically-stable-acute-pulmonary-embolism
#7
Hernan Polo Friz, Valeria Corno, Annalisa Orenti, Chiara Buzzini, Chiara Crivellari, Francesco Petri, Melisa Polo Friz, Veronica Punzi, Daniela Teruzzi, Luca Cavalieri d'Oro, Cristina Giannattasio, Giuseppe Vighi, Claudio Cimminiello, Patrizia Boracchi
Elderly patients presenting with acute pulmonary embolism (PE) frequently have significant underlying comorbidities which may condition the prognosis. The current study aimed to determine the ability of Charlson comorbidity index (CCI) score to predict short and long-term mortality in elderly patients with hemodynamically stable acute PE. All hemodynamically stable patients aged >65 years with acute PE, evaluated in the Emergency Department since 2010 through 2014, were included in this retrospective cohort study...
October 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28704383/predicting-in-hospital-death-during-acute-presentation-with-pulmonary-embolism-to-facilitate-early-discharge-and-outpatient-management
#8
Jerrett K Lau, Vincent Chow, Alex Brown, Leonard Kritharides, Austin C C Ng
BACKGROUND: Pulmonary embolism continues to be a significant cause of death. The aim was to derive and validate a risk prediction model for in-hospital death after acute pulmonary embolism to identify low risk patients suitable for outpatient management. METHODS: A confirmed acute pulmonary embolism database of 1,426 consecutive patients admitted to a tertiary-center (2000-2012) was analyzed, with odd and even years as derivation and validation cohorts respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28642976/prognostic-role-of-a-new-risk-index-for-the-prediction-of-30-day-cardiovascular-mortality-in-patients-with-acute-pulmonary-embolism-the-age-mean-arterial-pressure-index-amapi
#9
Marco Zuin, Gianluca Rigatelli, Claudio Picariello, Mauro Carraro, Pietro Zonzin, Loris Roncon
Acute pulmonary embolism (PE) is the third cause of cardiovascular (CV) mortality. We evaluated a new risk index, named Age-Mean Arterial Pressure Index (AMAPI), to predict 30-day CV mortality in patients with acute PE. Data of 209 patients (44.0% male and 56.0% female, mean age 70.58 ± 14.14 years) with confirmed acute PE were retrospectively analysed. AMAPI was calculated as the ratio between age and mean arterial pressure (MAP), which was defined as [systolic blood pressure + (2 × diastolic blood pressure)]/3...
December 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28280732/paroxysmal-atrial-fibrillation-in-the-course-of-acute-pulmonary-embolism-clinical-significance-and-impact-on-prognosis
#10
Agnieszka Krajewska, Katarzyna Ptaszynska-Kopczynska, Izabela Kiluk, Urszula Kosacka, Robert Milewski, Jacek Krajewski, Wlodzimierz Jerzy Musial, Bozena Sobkowicz
The relationship and clinical implications of atrial fibrillation (AF) in acute pulmonary embolism (PE) are poorly investigated. We aimed to analyze clinical characteristics and prognosis in PE patients with paroxysmal AF episode. Methods. From the 391 patients with PE 31 subjects with paroxysmal AF were selected. This group was compared with patients with PE and sinus rhythm (SR) and 32 patients with PE and permanent AF. Results. Paroxysmal AF patients were the oldest. Concomitant DVT varies between groups: paroxysmal AF 32...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28267465/assessment-of-right-ventricular-function-in-acute-pulmonary-embolism
#11
Deisy Barrios, Raquel Morillo, José Luis Lobo, Rosa Nieto, Ana Jaureguizar, Ana K Portillo, Esther Barbero, Covadonga Fernandez-Golfin, Roger D Yusen, David Jiménez
The optimal approach to assess right ventricular (RV) function in patients with acute symptomatic pulmonary embolism (PE) lacks clarity. METHODS: This study aimed to evaluate the optimal approach to assess RV function in normotensive patients with acute symptomatic PE. Outcomes assessed through 30-days after the diagnosis of PE included all-cause mortality and complicated course. RESULTS: Eight hundred forty-eight patients were enrolled. Multidetector computed tomography (MDCT) and transthoracic echocardiography agreed on the presence or absence of RV overload in 449 (53%) patients...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28238515/factors-influencing-hospital-stay-for-pulmonary-embolism-a-cohort-study
#12
Nuria Rodríguez-Núñez, Alberto Ruano-Raviña, Romina Abelleira, Lucía Ferreiro, Adriana Lama, Francisco J González-Barcala, Antonio Golpe, María E Toubes, José M Álvarez-Dobaño, Luis Valdés
INTRODUCTION: The aim of this study was to identify factors influencing hospital stay due to pulmonary embolism. METHODS: We performed a retrospective cohort study of patients hospitalized between 2010 and 2015. Patients were identified using information recorded in hospital discharge reports (ICD-9-CM codes 415.11 and 415.19). RESULTS: We included 965 patients with a median stay of 8 days (IQR 6-13 days). Higher scores on the simplified Pulmonary Embolism Severity Index (sPESI) were associated with increased probability of longer hospital stay...
February 23, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28213956/the-relation-between-international-normalized-ratio-and-mortality-in-acute-pulmonary-embolism-a-retrospective-study
#13
Tuncay Kırış, Selcuk Yazıcı, Gündüz Durmuş, Yiğit Çanga, Mustafa Karaca, Cem Nazlı, Abdullah Dogan
BACKGROUND: Acute pulmonary embolism (PE) is a serious clinical disease characterized by a high mortality rate. The aim of this study was to assess the prognostic value of international normalized ratio (INR) in acute PE patients not on anticoagulant therapy. METHODS: The study included 244 hospitalized acute PE patients who were not receiving previous anticoagulant therapy. Based on their 30-day mortality, patients were categorized as survivors or non-survivors...
January 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28185131/external-validation-of-a-claims-based-and-clinical-approach-for-predicting-post-pulmonary-embolism-outcomes-among-united-states-veterans
#14
Christine G Kohn, Erin R Weeda, Neela Kumar, Philip S Wells, W Frank Peacock, Gregory J Fermann, Li Wang, Onur Baser, Jeff R Schein, Concetta Crivera, Craig I Coleman
The In-hospital Mortality for PulmonAry embolism using Claims daTa (IMPACT) rule can accurately identify pulmonary embolism (PE) patients at low risk of early complications using claims data. We sought to externally validate the IMPACT and simplified Pulmonary Embolism Severity Index (sPESI) tools for predicting all-cause mortality and readmission. We used Veteran Health Administration data (10/1/2010-9/30/2015) to identify adults with ≥1 inpatient diagnosis code for acute PE, ≥12 months continuous medical and pharmacy benefits prior to the index PE, ≥90 days of post-event follow-up (unless death occurred) and ≥1 claim for an anticoagulant during the index PE stay...
August 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28011405/platelet-to-lymphocyte-ratio-as-a-novel-marker-of-in-hospital-and-long-term-adverse-outcomes-among-patients-with-acute-pulmonary-embolism-a-single-center-large-scale-study
#15
Elif Hande Ozcan Cetin, Mehmet Serkan Cetin, Ugur Canpolat, Ahmet Akdi, Dursun Aras, Ahmet Temizhan, Sinan Aydogdu
BACKGROUND: The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27997739/is-oxygen-saturation-variable-of-simplified-pulmonary-embolism-severity-index-reliable-for-identification-of-patients-suitable-for-outpatient-treatment
#16
Serhat Erol, Aslıhan Gürün Kaya, Fatma Arslan Ciftçi, Aydın Çiledağ, Elif Şen, Akın Kaya, Gökhan Çelik, İsmail Savaş
INTRODUCTION: The pulmonary embolism severity index (PESI) or simplified version (sPESI) are widely validated risk scores for the identification of eligible patients for outpatient treatment. Saturation is one of these criteria. For this metric, saturation of 90% or greater is assigned zero points. However, 90% saturation does not always exclude hypoxemic respiratory failure. OBJECTIVE: The aims of this study were first was to define corresponding partial arterial oxygen pressure (PaO2 ) values according to saturation in pulmonary embolism (PE) patients, and the second was to define a target saturation that can exclude hypoxemic respiratory failure and enable secure discharge of PE patients from emergency departments...
February 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27969570/red-cell-distribution-width-in-predicting-30-day-mortality-in-patients-with-pulmonary-embolism
#17
Xiao-Yu Zhou, Hong-Lin Chen, Song-Shi Ni
PURPOSE: The aim of the study was to investigate red cell distribution width (RDW) in predicting 30-day mortality in patients with pulmonary embolism (PE). METHODS: A single-center, retrospective study design was used between January 1, 2014, and February 1, 2016. The primary end point was 30-day mortality after admission. The RDW predicting value was assessed by receiver operating characteristic curves and area under the curve. RESULTS: A total of 309 patients with PE were included...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27764729/risk-stratifying-emergency-department-patients-with-acute-pulmonary-embolism-does-the-simplified-pulmonary-embolism-severity-index-perform-as-well-as-the-original
#18
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...
December 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27760781/biomarkers-for-clinical-decision-making-in-the-management-of-pulmonary-embolism
#19
REVIEW
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...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27752630/admission-rates-for-emergency-department-patients-with-venous-thromboembolism-and-estimation-of-the-proportion-of-low-risk-pulmonary-embolism-patients-a-us-perspective
#20
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: Clinical and Experimental Emergency Medicine
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