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Pulmonary embolism severity index

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https://www.readbyqxmd.com/read/28045743/role-of-survival-time-and-injury-severity-in-fatal-pulmonary-fat-embolism
#1
Juliane Jarmer, Garyfalia Ampanozi, Michael J Thali, Stephan A Bolliger
Pulmonary fat embolism (PFE) is frequent in blunt trauma and may occasionally lead to death. A correlation between fracture grade and severity and PFE grade has been described before, but no correlation between PFE and survival time, fat crushing extent, fat crush grade, or number of body regions with fractures could be noted in this small study. To further examine this, we decided to examine the aforementioned points in a far larger study group.Autopsy protocols of 188 nonresuscitated fatalities with blunt trauma and without right heart injury, which underwent whole body dissection, were retrospectively reviewed concerning the presence and the severity of PFE, injuries, survival time, age, sex, and the body mass index...
December 29, 2016: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28012721/the-clinical-severity-of-patients-diagnosed-with-an-in-hospital-pulmonary-embolism-following-modern-elective-joint-arthroplasty-is-unrelated-to-the-location-of-emboli-in-the-pulmonary-vasculature
#2
Alejandro Gonzalez Della Valle, Alvaro Blanes Perez, Yuo-Yu Lee, Gregory R Saboeiro, Gabrielle P Konin, Yoshimi Endo, Nigel E Sharrock, Eduardo A Salvati
BACKGROUND: In the event of a postoperative pulmonary embolism (PE), it is generally believed that patients with centrally located emboli will have worse clinical symptoms than those with segmental or subsegmental ones. We studied if a relationship exists between the clinical severity at the time of PE diagnosis and the location of the emboli within the pulmonary vasculature. METHODS: All 269 patients who developed an in-hospital, computed tomography pulmonary angiography-proved, in-hospital PE following elective total hip arthroplasty or total knee arthroplasty in our institution were studied...
November 25, 2016: Journal of Arthroplasty
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
#3
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...
December 10, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28007362/best-clinical-practice-controversies-in-outpatient-management-of-acute-pulmonary-embolism
#4
Brit Long, Alex Koyfman
BACKGROUND: Pulmonary embolism (PE) is a common condition managed in the emergency department (ED), with a wide range of morbidity and mortality. Patients are classically admitted for treatment and monitoring of anticoagulation. OBJECTIVE: We sought to evaluate the controversy concerning outpatient therapy for patients with acute PE and investigate the feasibility, safety, and efficacy of outpatient management. DISCUSSION: Patients with venous thromboembolism have historically been admitted for treatment and monitoring for concern of worsening disease or side effects of anticoagulation (bleeding)...
December 19, 2016: Journal of Emergency Medicine
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
#5
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...
December 20, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27969570/red-cell-distribution-width-in-predicting-30-day-mortality-in-patients-with-pulmonary-embolism
#6
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/27933648/ecg-gated-pulmonary-artery-cta-for-evaluation-of-right-ventricular-function-in-patients-with-acute-pulmonary-embolism
#7
Hong-Wei Liang, De-Li Zhao, Xin-Ding Liu, Peng Chen, Hai-Ting Zhou, Cheng-Lei Zhao, Guo-Kun Wang, Mei-Ling Xu, Jin-Ling Zhang
OBJECTIVE: To evaluate right ventricular function in patients with acute pulmonary embolism (APE) using electrocardiogram-gated CTA and to discuss the clinical value of pulmonary artery CTA PATIENTS AND METHODS: Based on death risk evaluation, 86 APE patients were divided into high-risk group (n=46) and non-high-risk group (n=40). The CT pulmonary embolism (PE) index and parameters of right ventricular function were analyzed from the CTPA images and compared between the two groups. Potential correlation between the two was also discussed...
December 9, 2016: Echocardiography
https://www.readbyqxmd.com/read/27925452/usefulness-of-admission-red-blood-cell-distribution-width-as-a-predictor-of-severity-of-acute-pulmonary-embolism
#8
Recep Akgedik, Harun Karamanli, Ali Bekir Kurt, Zeki Yüksel Günaydın
BACKGROUND: Previous researches have represented a considerable relation between acute pulmonary embolism (PE) and red blood cell distribution width (RDW). To the authors' knowledge no research has been informed in subjects with PE severity. Pulmonary arterial obstruction index (PAOI) is associated with the severity of acute PE. OBJECTIVES: In our investigation, we purposed to assess the relation between PAOI and RDW and the benefit of these factors in the detection of PE severity...
December 7, 2016: Clinical Respiratory Journal
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
#9
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
#10
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/27751702/prognostic-value-of-right-ventricular-dysfunction-markers-for-serious-adverse-events-in-acute-normotensive-pulmonary-embolism
#11
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
https://www.readbyqxmd.com/read/27727508/relation-between-lymphocyte-to-monocyte-ratio-and-short-term-mortality-in-patients-with-acute-pulmonary-embolism
#12
Ahmet Goktug Ertem, Cagri Yayla, Burak Acar, Ozgur Kirbas, Sefa Unal, Melahat Uzel Sener, Mehmet Kadri Akboga, Tolga Han Efe, Serkan Sivri, Fatih Sen, Serkan Gokaslan, Serkan Topaloglu
INTRODUCTION: The relationship between inflammation and mortality after acute pulmonary embolism (APE) has previously been investigated with different variables (platelet/lymphocyte ratio, etc). OBJECTIVES: We investigated the predictive value of lymphocyte to monocyte ratio (LMR) for mortality in first 30 days after APE. METHODS: The study population included 264 APE patients of which 230 patients were survivors, 34 patients were non-survivors...
October 11, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27693164/-outpatient-management-of-pulmonary-embolism-diagnosed-in-emergency-services
#13
E Dubie, G Pouzet, E Bohyn, C Meunier, A Wuyts, S Chateigner Coelsch, P Lesage, C Morvan, L Belle, G Vanzetto
In the emergency department, the management of patients with pulmonary embolism depends on the early mortality risk. Outpatient care is possible in low-risk patients. We present the existing scores and the strategy proposed by the North Alps Emergency Network, which uses the simplified PESI score (Pulmonary Embolism Severity Index) to select those low-risk patients, candidates for early discharge.
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27682367/association-between-inferior-vena-cava-filter-insertion-in-trauma-patients-and-in-hospital-and-overall-mortality
#14
Shayna Sarosiek, Denis Rybin, Janice Weinberg, Peter A Burke, George Kasotakis, J Mark Sloan
Importance: Trauma patients admitted to the hospital are at increased risk of bleeding and thrombosis. The use of inferior vena cava (IVC) filters in this population has been increasing, despite a lack of high-quality evidence to demonstrate their efficacy. Objective: To determine if IVC filter insertion in trauma patients affects overall mortality. Design, Setting, and Participants: This retrospective cohort study used stratified 3:1 propensity matching to select a control population similar to patients who underwent IVC filter insertion at Boston Medical Center (a level I trauma center at Boston University School of Medicine) between August 1, 2003, and December 31, 2012...
September 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27652375/optimizing-clinical-decision-support-in-the-electronic-health-record-clinical-characteristics-associated-with-the-use-of-a-decision-tool-for-disposition-of-ed-patients-with-pulmonary-embolism
#15
Dustin W Ballard, Ridhima Vemula, Uli K Chettipally, Mamata V Kene, Dustin G Mark, Andrew K Elms, James S Lin, Mary E Reed, Jie Huang, Adina S Rauchwerger, David R Vinson
OBJECTIVE: Adoption of clinical decision support (CDS) tools by clinicians is often limited by workflow barriers. We sought to assess characteristics associated with clinician use of an electronic health record-embedded clinical decision support system (CDSS). METHODS: In a prospective study on emergency department (ED) activation of a CDSS tool across 14 hospitals between 9/1/14 to 4/30/15, the CDSS was deployed at 10 active sites with an on-site champion, education sessions, iterative feedback, and up to 3 gift cards/clinician as an incentive...
September 21, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27647364/the-accuracy-of-combined-use-of-troponin-and-red-cell-distribution-width-in-predicting-mortality-of-patients-with-acute-pulmonary-embolism
#16
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...
December 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27614370/the-prognostic-importance-of-thiol-disulfide-homeostasis-in-patients-with-acute-pulmonary-thromboembolism
#17
Mustafa Topuz, Mehmet Kaplan, Oguz Akkus, Omer Sen, Hatem Dilek Yunsel, Samir Allahverdiyev, Ozcan Erel, Mevlut Koc, Mustafa Gur
OBJECTIVE: The aim of this study was to evaluate the role of thiol/disulfide homeostasis in acute pulmonary embolism (APE) and investigate its compliance to show hospital mortality of patients with APE. MATERIAL AND METHODS: A total of 173 participants including 113 patients with APE, and 60 healthy individuals were included in the study. APE group was categorized into two subgroups according to Pulmonary Embolism Severity Index (PESI) clinic risk score (PESI low group [n=71, class 1-3] and PESI high group [n=42, class 4-5])...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27591768/ct-pulmonary-angiography-based-scoring-system-to-predict-the-prognosis-of-acute-pulmonary-embolism
#18
Kanako K Kumamaru, Sachin S Saboo, Ayaz Aghayev, Phoebe Cai, Carlos Gonzalez Quesada, Elizabeth George, Zoha Hussain, Tianrun Cai, Frank J Rybicki
BACKGROUND: The purpose is to develop a comprehensive risk-scoring system based on CT findings for predicting 30-day mortality after acute pulmonary embolism (PE), and to compare it with PE Severity Index (PESI). MATERIALS AND METHODS: The study included consecutive 1698 CT pulmonary angiograms (CTPA) positive for acute PE performed at a single institution (2003-2010). Two radiologists independently assessed each study regarding clinically relevant findings and then performed adjudication...
November 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27548074/rivaroxaban-versus-heparin-bridging-to-warfarin-therapy-impact-on-hospital-length-of-stay-and-treatment-costs-for-low-risk-patients-with-pulmonary-embolism
#19
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
https://www.readbyqxmd.com/read/27537530/multicenter-trial-of-rivaroxaban-for-early-discharge-of-pulmonary-embolism-from-the-emergency-department-mercury-pe-rationale-and-design
#20
Adam J Singer, Jim Xiang, Christopher Kabrhel, Gino J Merli, Charles Pollack, Victor F Tapson, Peter Wildgoose, W Frank Peacock
OBJECTIVES: Traditionally, patients with pulmonary embolism (PE) are admitted from the emergency department and treated with low-molecular-weight heparin followed by warfarin. Several studies now demonstrate that it is possible to identify low-risk PE patients that can safely be treated as outpatients. The advent of the direct-acting oral anticoagulants such as rivaroxaban has made it easier than ever to manage patients outside of the hospital. This article describes the design of a randomized controlled trial aimed at testing the hypothesis that low-risk PE patients can be safely and effectively managed at home using rivaroxaban, resulting in fewer days of hospitalization than standard-of-care treatment...
November 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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