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Semin Respir Crit Care Med 2017; 38(01): 011-017
DOI: 10.1055/s-0036-1597556
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risk Stratification for Proven Acute Pulmonary Embolism: What Information Is Needed?

Deisy Barrios
1   Respiratory Department, Ramón y Cajal Hospital, IRYCIS, Alcala de Henares University, Madrid, Spain
,
Roger D. Yusen
2   Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri
3   Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri
,
David Jiménez
1   Respiratory Department, Ramón y Cajal Hospital, IRYCIS, Alcala de Henares University, Madrid, Spain
› Institutsangaben
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Publikationsdatum:
16. Februar 2017 (online)

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Abstract

Classification of risk drives treatment decisions for patients with acute symptomatic pulmonary embolism (PE). High-risk patients with acute symptomatic PE have hemodynamic instability (i.e., shock or hypotension present), and treatment guidelines suggest systemically administered thrombolytic therapy in this setting. Normotensive PE patients at low risk for early complications (low-risk PE) might benefit from treatment at home or early discharge, while normotensive patients with preserved systemic arterial pressure deemed as having a high risk for PE-related adverse clinical events (intermediate–high-risk PE) might benefit from close observation and consideration of escalation of therapy. Prognostic tools (e.g., clinical prognostic scoring systems, imaging testing, and cardiac laboratory biomarkers) assist with the classification of patients into these categories.

Keywords

pulmonary embolism - prognosis - mortality