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https://www.readbyqxmd.com/read/28890217/saddle-vs-nonsaddle-pulmonary-embolism-clinical-presentation-hemodynamics-management-and-outcomes
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
February 18, 2017: 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27751702/prognostic-value-of-right-ventricular-dysfunction-markers-for-serious-adverse-events-in-acute-normotensive-pulmonary-embolism
#16
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)...
February 2017: Journal of Emergency Medicine
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
#17
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/27548074/rivaroxaban-versus-heparin-bridging-to-warfarin-therapy-impact-on-hospital-length-of-stay-and-treatment-costs-for-low-risk-patients-with-pulmonary-embolism
#18
COMPARATIVE STUDY
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/27357135/prognostic-value-of-d-dimer-in-elderly-patients-with-pulmonary-embolism
#19
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
https://www.readbyqxmd.com/read/27208461/on-the-necessity-of-new-decision-making-methods-for-cancer-associated-symptomatic-pulmonary-embolism
#20
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
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