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Pulmonary embolism severity index

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https://www.readbyqxmd.com/read/29915643/predictors-of-hospital-stay-in-normotensive-acute-pulmonary-embolism-a-retrospective-pilot-study
#1
Osama Mukhtar, Oday Alhafidh, Mazin Khalid, Jaspreet Kaler, Ebad Rahman, Binav Shrestha, Manal Bakhiet, Sumit Dahal, Bikash Bhattarai, Praveen Datar, Omar Abdulfattah, Vijay Gayam, Joseph Quist, Danilo Enriquez, Frances Schmidt
Introduction : The aim of our study is to determine the clinical, biochemical, and imaging factors that affect the duration of hospital stay in patients admitted with normotensive acute pulmonary embolism. Methods : This was a single-center retrospective study conducted in a community hospital in New York metropolitan area for patients admitted from October 2015 to October 2017. Results : A total of 79 patients were included, the mean age was 55.76 ( SD  = 17.33), 29 cases were males (37%) and 50 cases were females (63%)...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29898910/fulminant-pulmonary-embolism-with-fatal-outcome-in-a-patient-with-low-clinical-prediction-scores
#2
Christian Degen, Severin Poechtrager, Gregor Leibundgut
We present a case of a 72-year-old man with submassive acute pulmonary thromboembolism. Pulmonary embolism severity index Score and common clinical risk stratification recommended systemic anticoagulation and a clinical course without complications was expected. A primary reperfusion strategy was not indicated by the current guidelines. Under established anticoagulation, the patient was found in cardiac arrest immediately after mobilisation from the bed the next morning. Right heart catheterisation under ongoing resuscitation revealed a complete obstruction of the right pulmonary artery by a big thrombus...
June 13, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29850139/early-surgical-treatment-in-patients-with-pulmonary-embolism-and-thrombus-in-transit
#3
Francisco Galeano-Valle, Pablo Demelo-Rodríguez, Irene García-Fernández-Bravo, Hugo Rodríguez-Abella, Ángela Irabien-Ortiz, Ramón Fortuny-Ribas, Jorge Del Toro-Cervera
Background: Floating right heart thrombi (RHT) are in transit from the legs to the pulmonary arteries and thus are a severe form of venous thromboembolism (VTE), with a high early mortality rate without treatment. There is a lack of evidence-based recommendations for its management. The objective of this study is to describe our experience in the surgical management of thrombus-in-transit and pulmonary embolism (PE) in a tertiary hospital. Methods: We recruited four patients with thrombus-in-transit and PE treated with early surgical embolectomy and anticoagulation...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29843172/initial-and-long-term-treatment-of-pulmonary-embolism-current-approach-and-future-perspectives
#4
Marco P Donadini, Walter Ageno
Pulmonary embolism is associated with variable risk of early mortality, ranging from less than 1% to more than 15%. Risk stratification, based on clinical variables and signs of right ventricular dysfunction, is crucial to decide the best management and treatment strategy. Home therapy may be an option for low-risk patients, whereas patients at intermediate risk need to be hospitalized and some of them, at intermediate high risk, may require more intensive monitoring to early detect signs of haemodynamic decompensation...
May 2018: Hämostaseologie
https://www.readbyqxmd.com/read/29806471/d-dimer-assessment-improves-the-simplified-pulmonary-embolism-severity-index-for-in-hospital-risk-stratification-in-acute-pulmonary-embolism
#5
Marta Kozlowska, Magdalena Plywaczewska, Marcin Koc, Szymon Pacho, Anna Wyzgal, Olga Zdonczyk, Aleksandra Furdyna, Michal Ciurzynski, Katarzyna Kurnicka, Krzysztof Jankowski, Anna Lipinska, Piotr Palczewski, Piotr Bienias, Piotr Pruszczyk
d-dimer (DD) levels are used in the diagnostic workup of suspected acute pulmonary embolism (APE), but data on DD for early risk stratification in APE are limited. In this post hoc analysis of a prospective observational study of 270 consecutive patients, we aimed to optimize the discriminant capacity of the simplified pulmonary embolism severity index (sPESI), an APE risk assessment score currently used, by combining it with DD for in-hospital adverse event prediction. We found that DD levels were higher in patients with complicated versus benign clinical course 7...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29794762/successful-treatment-of-multisite-hemorrhage-by-several-methods-in-brain-metastasis-of-choriocarcinoma-a-case-report
#6
Zhen Ren, Li Yu, Mengnv Xie, Yiyi Liang, Fang Zhu, Rui Huang, Zhibang Zhang, Chun Fu
RATIONALE: Brain metastasis of choriocarcinoma is a highly malignant gestational trophoblastic neoplasia (GTN) and has a notoriously poor prognosis. Hemorrhagic choriocarcinoma lesions may lead to life-threatening conditions also. Treatment of brain metastases of choriocarcinoma with hemorrhage in multiple sites is very difficult in clinical practices. A patient has been successfully treated in our hospital, which provides as clinical references for this difficulty in treating brain metastases of choriocarcinoma with hemorrhage in multiple sites...
May 2018: Medicine (Baltimore)
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
#7
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/29760849/acute-pulmonary-embolism-in-emergency-department-patients-despite-therapeutic-anticoagulation
#8
Michelle Y Liu, Dustin W Ballard, Jie Huang, Adina S Rauchwerger, Mary E Reed, Sean C Bouvet, David R Vinson
Introduction: Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered and present a diagnostic and management challenge. Their characterization and outcomes are poorly described. We sought to describe the prevalence and characteristics of therapeutically anticoagulated patients among a population of patients with acute PE in a community setting and to describe treatment changes and 30-day outcomes...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29750055/noncommunicable-disease-and-multimorbidity-in-young-adults-with-cerebral-palsy
#9
Daniel G Whitney, Edward A Hurvitz, Jennifer M Ryan, Maureen J Devlin, Michelle S Caird, Zachary P French, Elie C Ellenberg, Mark D Peterson
Purpose: Individuals with cerebral palsy (CP) are at increased risk for frailty and chronic disease due to factors experienced throughout the lifespan, such as excessive sedentary behaviors and malnutrition. However, little is known about noncommunicable diseases (NCDs) and multimorbidity profiles in young adults with CP. The study objective was to compare NCD and multimorbidity profiles between young adults with and without CP. Methods: A clinic-based sample of adults (18-30 years) with (n=452) and without (n=448) CP was examined at the University of Michigan Medical Center...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29745451/electronic-cardiac-arrest-triage-score-best-predicts-mortality-after-intervention-in-patients-with-massive-and-submassive-pulmonary-embolism
#10
Taishi Hirai, Steven Tate, Kathryn Dryer, Deshon Jones, Jonathan Rosenberg, Sandeep Nathan, Atman P Shah, Kyle Carey, Matthew Churpek, Dana Edelson, Janet Friant, Jonathan Paul, John E A Blair
OBJECTIVE: To determine if the cardiac arrest triage (CART) Score would better predict poor outcomes after pharmacomechanical therapy (PMT) for massive and submassive pulmonary embolism (PE) than traditional risk scores BACKGROUND: PMT for massive and submassive PE allows for clot lysis with minimal doses of fibrinolytics. Although PMT results in improved right ventricular function, and reduced pulmonary pressures and thrombus burden, predictors of poor outcome are not well-studied. METHODS: We conducted a retrospective analysis of all patients who underwent PMT for massive or submassive PE at a single institution from 2010 to 2016...
May 10, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29733493/prediction-of-short-term-prognosis-in-elderly-patients-with-acute-pulmonary-embolism-validation-of-the-riete-score
#11
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/29720096/celiac-crisis-a-rare-and-profound-presentation-of-celiac-disease-a-case-report
#12
Elizabeth Ann Forrest, Mark Wong, Srinivasa Nama, Siddharth Sharma
BACKGROUND: Celiac crisis is a life-threatening manifestation of celiac disease and is rare in adults, with only a handful of cases documented worldwide and mostly in children. CASE PRESENTATION: A profoundly emaciated 43-year-old female presented with profuse diarrhoea, shortness of breath, left leg swelling with ulceration and immobility (Body Mass Index (BMI) = 14.7 kg/m2 ). The patient had normal anion-gap metabolic acidosis (pH = 7.16) with persisting hypokalemia, hyponatremia, hypomagnesemia and hypophosphatemia...
May 2, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29707339/effect-of-low-molecular-weight-heparin-on-venous-thromboembolism-disease-in-thoracotomy-patients-with-cancer
#13
Jun Dong, Jia Wang, Yuan Feng, Li-Ping Qi, Hua Fang, Guo-Dong Wang, Zhou-Qiao Wu, Hong-Zhi Wang, Yue Yang, Qing Li
Background: Much attention has been given to venous thromboembolism (VTE) disease, and many guidelines for prophylaxis have been published. However, there are few published data on patients who underwent thoracotomy. This study is to compare the effect of low molecular weight heparin (LMWH) combined mechanical approaches with mechanical approaches alone in prevention of VTE in the post thoracotomy cancer patients. Methods: This study used a prospective, randomized-controlled design...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29703009/acute-respiratory-failure-requiring-mechanical-ventilation-in-severe-chronic-obstructive-pulmonary-disease-copd
#14
Shruti K Gadre, Abhijit Duggal, Eduardo Mireles-Cabodevila, Sudhir Krishnan, Xiao-Feng Wang, Katrina Zell, Jorge Guzman
There are limited data on the epidemiology of acute respiratory failure necessitating mechanical ventilation in patients with severe chronic obstructive pulmonary disease (COPD). The prognosis of acute respiratory failure requiring invasive mechanical ventilation is believed to be grim in this population. The purpose of this study was to illustrate the epidemiologic characteristics and outcomes of patients with underlying severe COPD requiring mechanical ventilation.A retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between January 2008 and December 2012 with a diagnosis of severe COPD and requiring invasive mechanical ventilation for acute respiratory failure...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29694453/cardiac-troponins-in-low-risk-pulmonary-embolism-patients-a-systematic-review-and-meta-analysis
#15
Omar S Darwish, Abdullah Mahayni, Mukti Patel, Alpesh Amin
BACKGROUND: Patients with low-risk pulmonary embolism (PE) should be considered as per current scoring systems for ambulatory treatment. However, there is uncertainty whether patients with low scores and positive troponins should require hospitalization. METHODS: We searched MEDLINE, SCOPUS, and Cochrane Library databases from inception to December 2016 and collected longitudinal studies that evaluated the prognostic value of troponins in patients with low-risk PE...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29693295/red-blood-cell-transfusion-and-outcomes-in-acute-pulmonary-embolism
#16
Christopher C Y Wong, Wallace W K Chow, Jerrett K Lau, Vincent Chow, Austin C C Ng, Leonard Kritharides
BACKGROUND AND OBJECTIVE: Blood transfusion has been associated with adverse outcomes in certain conditions. This study investigates the prevalence and outcomes of red blood cell (RBC) transfusion in patients with acute pulmonary embolism (PE). METHODS: Retrospective study of consecutive patients from 2000 to 2012 admitted to a tertiary hospital with a primary diagnosis of acute PE. Transfusion status during the hospital admission was ascertained. Mortality was tracked from a state-wide death database and analysed using multivariable modelling...
April 24, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29675617/is-acute-pulmonary-embolism-more-severe-in-the-presence-of-obstructive-sleep-apnea-results-from-an-observational-cohort-study
#17
Dinah Konnerth, Florian Schwarz, Michael Probst, Martin Seidler, Tanja Wagner, Christian Faul, Wolfgang von Scheidt, Martin Schwaiblmair, Thomas M Berghaus
Obstructive sleep apnea (OSA) might influence disease severity in acute pulmonary embolism (PE). 253 survivors of acute PE were evaluated for sleep-disordered breathing by portable monitoring and nocturnal polysomnography. PE patients with an apnea-hypopnoea index (AHI) ≥ 15/h were significantly older (p < 0.001), had significantly impaired renal (p < 0.001) and left ventricular functions (p = 0.003), showed significantly elevated troponin I (p = 0.005) and D-dimer levels (p = 0...
April 19, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29577524/pulmonary-infarction-secondary-to-pulmonary-embolism-an-evolving-paradigm
#18
Marjan Islam, Jason Filopei, Matthew Frank, Navitha Ramesh, Stacey Verzosa, Madeline Ehrlich, Eric Bondarsky, Albert Miller, David Steiger
BACKGROUND AND OBJECTIVE: Pulmonary infarction (PI) from pulmonary embolism (PE) remains an entity of unclear aetiology. PI has been thought to occur in elderly patients with cardiopulmonary disease. We hypothesize younger patients without cardiopulmonary comorbidities are at highest risk. Our study aims to characterize PI clinically and radiographically, determine associated risk factors and determine their clinical significance. METHODS: We conducted a single-centre retrospective review of 367 consecutive patients with PE...
March 25, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29567899/autopsy-findings-in-an-atypical-case-of-occult-massive-fatal-pulmonary-embolism-in-a-backdrop-of-hyperhomocysteinemia
#19
Pratibha Misra, Arijit Kumar Ghosh, Aneeta Jassar
A 43-year-old apparently healthy male presented with fever and presyncope. He was suspected to have massive pulmonary thromboembolism based on the clinico-biochemical profile. Despite aggressive thrombolytic therapy, he succumbed to his illness within 12 h of admission. Postmortem examination showed massive pulmonary thromboembolism and hyperhomocysteinemia with low high-density lipoproteins (HDL) cholesterol with antemortem blood sample. Herein, we report autopsy findings in a rare case of a young male with occult massive pulmonary thromboembolism without deep vein thrombosis, who had an atypical clinical presentation and was found to have underlying hyperhomocysteinemia and decreased HDLc...
January 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29504991/delayed-retroperitoneal-arterial-hemorrhage-after-inferior-vena-cava-filter-deployment-a-case-report
#20
Yongzheng Wang, Haiyang Chang, Wujie Wang, Wei Wang, Bin Liu, Zheng Li, Yuliang Li
RATIONALE: Pulmonary embolization is a life-threatening condition. The deployment of inferior vena cava (IVC) filter is the first choice for preventing embolus from the lower extremity. However, IVC filter complications are rare but not to be neglected. Penetration of the arterial wall may result in catastrophic damages. This case report describes a woman who suffered from retroperitoneal hemorrhage after placement of an IVC filter due to a pulmonary embolization. Her filter was found to have penetrated the right lumbar artery and caused the massive bleeding...
January 2018: Medicine (Baltimore)
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