Pulmonary embolism: a retrospective comparative study between patients with atypical vs typical clinical presentation
Pulmonary embolism: a retrospective comparative study between patients with atypical vs typical clinical presentation.
Adolescent
Adult
Aged
Aged, 80 and over
Chest Pain
/ epidemiology
Dyspnea
/ epidemiology
Emergency Service, Hospital
Female
Hemoptysis
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Length of Stay
Male
Middle Aged
Prognosis
Pulmonary Embolism
/ diagnosis
Retrospective Studies
Tomography, X-Ray Computed
Ventricular Dysfunction, Right
/ epidemiology
Young Adult
Journal
Recenti progressi in medicina
ISSN: 2038-1840
Titre abrégé: Recenti Prog Med
Pays: Italy
ID NLM: 0401271
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
entrez:
8
3
2019
pubmed:
8
3
2019
medline:
14
11
2019
Statut:
ppublish
Résumé
Natural history and outcomes of patients with pulmonary embolism (PE) without typical
symptoms (atypical PE) remain unclear. The aim of the study is to compare the clinical characteristics and the prognosis between typical PE and atypical PE. We retrospectively analyzed data from consecutive patients admitted to the Emergency Department (ED) because of a diagnosis of PE and classified them in two groups: typical
PE and atypical PE. We defined PE to be typical in presence of almost one of the following symptoms or signs: dyspnea, chest pain, hemoptysis or signs of deep vein thrombosis. Of the 191 patients with PE, 154 (81%) had typical PE and 37 (19%) had atypical PE. Patients with atypical and typical PE seemed to had similar prognostic factor such as high risk sPESI (73% vs 65%, p=0.3), right ventricular dysfunction (30% vs 26%, p=0.6) and central PE at chest CT scan (38% vs 36%, p=0.8). The rate of 30 day mortality was 7% in the typical group and 8% in the atypical group (p=0.8). The length of stay in hospital was
the same in the two groups (6 days; p=0.2). We found that atypical and typical PE seem to be related diseases with a similar short term prognosis. Therefore, we could speculate that a missed diagnosis of PE in ED could expose the patients to a worsen prognosis. Further perspective studies are required for better investigate this diagnostic challenge.
Sections du résumé
Background
Natural history and outcomes of patients with pulmonary embolism (PE) without typical
symptoms (atypical PE) remain unclear. The aim of the study is to compare the clinical characteristics and the prognosis between typical PE and atypical PE.
Methods
We retrospectively analyzed data from consecutive patients admitted to the Emergency Department (ED) because of a diagnosis of PE and classified them in two groups: typical
PE and atypical PE. We defined PE to be typical in presence of almost one of the following symptoms or signs: dyspnea, chest pain, hemoptysis or signs of deep vein thrombosis.
Results
Of the 191 patients with PE, 154 (81%) had typical PE and 37 (19%) had atypical PE. Patients with atypical and typical PE seemed to had similar prognostic factor such as high risk sPESI (73% vs 65%, p=0.3), right ventricular dysfunction (30% vs 26%, p=0.6) and central PE at chest CT scan (38% vs 36%, p=0.8). The rate of 30 day mortality was 7% in the typical group and 8% in the atypical group (p=0.8). The length of stay in hospital was
the same in the two groups (6 days; p=0.2).
Conclusions
We found that atypical and typical PE seem to be related diseases with a similar short term prognosis. Therefore, we could speculate that a missed diagnosis of PE in ED could expose the patients to a worsen prognosis. Further perspective studies are required for better investigate this diagnostic challenge.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM