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https://www.readbyqxmd.com/read/28472317/surgical-embolectomy-for-high-risk-acute-pulmonary-embolism-is-standard-therapy
#1
Daisuke Shiomi, Hiroshi Kiyama, Masatsugu Shimizu, Muneaki Yamada, Naohiro Shimada, Aya Takahashi, Nobuaki Kaki
OBJECTIVES: Acute massive pulmonary embolism (AMPE) is a life-threatening condition that often induces rapid haemodynamic deterioration. The mortality of surgical embolectomy is still poor in patients with preoperative cardiopulmonary arrest (CPA). We analysed the outcome of surgical pulmonary embolectomy for haemodynamically unstable patients. METHODS: Thirty-one patients underwent surgical embolectomy for haemodynamically unstable AMPE. The indications for surgical embolectomy were (i) <7 days from onset, (ii) haemodynamically unstable, (iii) massive clots in bilateral pulmonary arteries or unilateral pulmonary artery occlusion with a floating clot in the main pulmonary artery or right atrium and (iv) right ventricular dilatation in transthoracic echocardiography...
May 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28106343/net-clinical-benefit-of-hospitalization-versus-outpatient-management-of-patients-with-acute-pulmonary-embolism
#2
P-M Roy, D J Corsi, M Carrier, A Theogene, C de Wit, C Dennie, G Le Gal, A Delluc, T Moumneh, M Rodger, P Wells, E Gandara
Essentials Clinical benefit of hospitalization vs. outpatient treatment in pulmonary embolism (PE) is unknown. We performed a propensity matched cohort study of hemodynamically stable PE patients. Regardless of the risk assessment, hospitalized patients had the highest rate of adverse event. If confirmed, ambulatory care of normotensive PE patients may be preferred whenever possible. SUMMARY: Background The decision to hospitalize or not patients with acute pulmonary embolism (PE) is controversial...
April 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28066591/relationship-between-polycythemia-and-in-hospital-mortality-in-chronic-obstructive-pulmonary-disease-patients-with-low-risk-pulmonary-embolism
#3
Lu Guo, Aamer Rasheed Chughtai, Hongli Jiang, Lingyun Gao, Yan Yang, Yang Yang, Yuejian Liu, Zhenliang Xie, Weimin Li
BACKGROUNDS: Pulmonary embolism (PE) is frequent in subjects with chronic obstructive pulmonary disease (COPD) and associated with high mortality. This multi-center retrospective study was performed to investigate if secondary polycythemia is associated with in-hospital mortality in COPD patients with low-risk PE. METHODS: We identified COPD patients with proven PE between October, 2005 and October, 2015. Patients in risk classes III-V on the basis of the PESI score were excluded...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28052963/symptoms-signs-suspicion-and-setting-a%C3%A2-pesi-score-for-cancer-associated-pulmonary-embolism
#4
EDITORIAL
Florian Posch, Cihan Ay
No abstract text is available yet for this article.
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28007362/best-clinical-practice-controversies-in-outpatient-management-of-acute-pulmonary-embolism
#5
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
#6
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/27764729/risk-stratifying-emergency-department-patients-with-acute-pulmonary-embolism-does-the-simplified-pulmonary-embolism-severity-index-perform-as-well-as-the-original
#7
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
#8
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/27693164/-outpatient-management-of-pulmonary-embolism-diagnosed-in-emergency-services
#9
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/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
#10
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/27620305/symptomatology-clinical-presentation-and-basic-work-up-in-patients-with-suspected-pulmonary-embolism
#11
Poul Henning Madsen, Søren Hess
Basic knowledge of pulmonary embolism is relevant to most practicing physicians. Many medical specialties care for patients with increased risk of pulmonary embolism, why recognition of relevant symptoms, a thorough medical history, assessment of the clinical condition of the patient and possibly referral to a relevant facility should be a part of the skills of all clinicians. Sudden onset dyspnea, chest pain, syncope and hemoptysis are essential symptoms of pulmonary embolism, and in most of these patients basic investigations like arterial blood gas analysis, electrocardiogram, chest x-ray and biochemical analyses are appropriate...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27614370/the-prognostic-importance-of-thiol-disulfide-homeostasis-in-patients-with-acute-pulmonary-thromboembolism
#12
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
#13
COMPARATIVE STUDY
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/27391003/prognostic-value-of-the-simplified-pesi-score-in-comparison-with-the-2014-esc-risk-model-in-pulmonary-embolism
#14
Mihaela Cordeanu, Sébastien Gaertner, Alix Faller, Corina Mirea, Isabelle Le Ray, Dominique Stephan
No abstract text is available yet for this article.
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27306263/high-sensitivity-troponin-and-right-ventricular-function-in-acute-pulmonary-embolism
#15
Gustavo Daquarti, Nicolás March Vecchio, Cecilia Soledad Mitrione, Juan Furmento, María Clara Ametrano, María Paz Dominguez Pace, Juan Pablo Costabel
INTRODUCTION: Right ventricular (RV) dysfunction has proved to be an important predictor of morbidity and mortality in patients with pulmonary embolism (PE). Tricuspid annular plane systolic excursion (TAPSE) is one of the parameters that have been validated as predictor of outcomes. The aim of our study was to evaluate the performance (sensitivity and specificity) of high-sensitivity cardiac troponin T (hs-cTnT) to predict RV dysfunction defined as TAPSE <16 mm. METHODS: We conducted a single-center retrospective analysis of 40 patients prospectively included...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27274172/assessment-of-prognostic-value-of-neutrophil-to-lymphocyte-ratio-and-platelet-to-lymphocyte-ratio-in-patients-with-pulmonary-embolism
#16
Mehmet Baran Karataş, Göktürk İpek, Tolga Onuk, Barış Güngör, Gündüz Durmuş, Yiğit Çanga, Yasin Çakıllı, Osman Bolca
BACKGROUND: Acute pulmonary embolism is a serious medical condition that has a substantial global impact. Inflammation plays a role in the pathophysiology and prognosis of acute pulmonary embolism (APE). The aim of the present study was to investigate the prognostic value of admission parameters for complete blood count (CBC) in APE. METHODS: A total of 203 patients who were hospitalized with diagnosed APE were retrospectively enrolled in the study. Clinical data, PESI scores, admission CBC parameters, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were all recorded...
May 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27208461/on-the-necessity-of-new-decision-making-methods-for-cancer-associated-symptomatic-pulmonary-embolism
#17
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/27188056/-prognostic-scores-for-pulmonary-embolism
#18
Alain Junod
Nine prognostic scores for pulmonary embolism (PE), based on retrospective and prospective studies, published between 2000 and 2014, have been analyzed and compared. Most of them aim at identifying PE cases with a low risk to validate their ambulatory care. Important differences in the considered outcomes: global mortality, PE-specific mortality, other complications, sizes of low risk groups, exist between these scores. The most popular score appears to be the PESI and its simplified version. Few good quality studies have tested the applicability of these scores to PE outpatient care, although this approach tends to already generalize in the medical practice...
March 23, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/27174887/acute-pulmonary-embolism-mortality-prediction-by-the-2014-european-society-of-cardiology-risk-stratification-model
#19
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
https://www.readbyqxmd.com/read/27075811/thromboembolic-burden-prognostic-assessment-and-outcomes-of-females-compared-to-males-in-acute-pulmonary-embolism
#20
MULTICENTER STUDY
Grazia Panigada, Luca Masotti, Claudia Rosi, Laila Teghini, Barbara Cimolato, Maria Chiara Bertieri, Chiara Angotti, Anna Maria Romagnoli, Irene Cascinelli, Veronica De Crescenzo, Alba Dainelli, Giuseppa Levantino, Lucia Raimondi, Rossella Nassi, Roberta Mastriforti, Paola Lambelet, Valentina Carli, Anna Frullini, Maddalena Grazzini, Lucia Ciucciarelli, Sara Bucherelli, Alessandra Petrioli, Carlotta Casati
BACKGROUND: Literature lacks on sex differences in acute pulmonary embolism (PE). Therefore, the aim of our study was to provide information about sex difference in thromboembolic burden, prognostic assessment and outcomes of PE. MATERIALS AND METHODS: We analyzed and compared differences between females and males retrieving data of a multicenter, observational, retrospective, cohort study aimed to analyze characteristics of PE patients admitted in Internal Medicine wards of Tuscany, Italy...
June 2016: Acta Clinica Belgica
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