Thromb Haemost 2008; 100(05): 937-942
DOI: 10.1160/TH08-02-0065
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

Short-term clinical outcome after acute symptomatic pulmonary embolism

Francisco Conget
1  Department of Medicine, Psychiatry and Dermatology, Lozano Blesa Hospital and Zaragoza University, Zaragoza, Spain
,
Remedios Otero
2  Respiratory Department, Virgen del Rocío Hospital, Sevilla, Spain
,
David Jiménez
3  Respiratory Department, Ramón y Cajal Hospital, Madrid, Spain; Department of Medicine. Alcalá de Henares University
,
David Martí
3  Respiratory Department, Ramón y Cajal Hospital, Madrid, Spain; Department of Medicine. Alcalá de Henares University
,
Carlos Escobar
3  Respiratory Department, Ramón y Cajal Hospital, Madrid, Spain; Department of Medicine. Alcalá de Henares University
,
Consolación Rodríguez
2  Respiratory Department, Virgen del Rocío Hospital, Sevilla, Spain
,
Fernando Uresandi
4  Respiratory Department, Cruces Hospital, Bizkaia, Spain
,
Miguel Angel Cabezudo
5  Respiratory Department, Oviedo Hospital, Oviedo, Spain
,
Dolores Nauffal
6  Respiratory Department, La Fe Hospital, Valencia, Spain
,
Mikel Oribe
7  Respiratory Department, Galdakao Hospital, Galdakao, Spain
,
Roger Yusen
8  Divisions of Pulmonary and Critical Care Medicine and General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
› Author Affiliations
Financial support: D. Jiménez, R. Otero, F . Uresandi, D. Nauffal, C. Rodríguez, F . Conget, M.Oribe, and MA Cabezudo are investigators in the “Cooperative study for the ambulatory treatment of patients with pulmonary embolism” research study group.
Further Information

Publication History

Received 03 February 2008

Accepted after major revision 09 August 2008

Publication Date:
22 November 2017 (online)

Summary

Though studies have identified clinical variables that predict adverse events in patients with acute pulmonary embolism (PE), they have typically not differentiated short-term from long-term predictors.This multicenter prospective cohort study included consecutive outpatients with objectively confirmed symptomatic acute PE.We analyzed the incidence and time course of death, venous thromboembolism (VTE) recurrence, and major bleeding, and we compared event rates during short-term (first week) and long-term (3 months) follow-up after the diagnosis of PE.We also assessed risk factors for short-term mortality. During the first three months after diagnosis of PE, 142 of 1,338 (10.6%) patients died.Thirty-six deaths (2.7%) occurred during the first week after diagnosis of PE,and 61.1% of these were due to PE.Thirty-eight patients (2.8%) had recurrent VTE during the three-month follow-up, though none of the recurrences occurred during the first week after diagnosis of PE. During the three-month follow-up, major bleeding occurred in 48 patients (3.6%). Twenty-one (1.6%) major bleeds occurred during the first week of follow-up,and nine of these were fatal. Short-term mortality was significantly increased in patients who initially presented with systolic arterial hypotension (odds ratio [OR] 3.35; 95% CI, 1.51-5.41) or immobilization due to a medical illness (OR 2.89; 95% confidence interval [CI], 1.31-6.39).In con-clusion,during the first week after the diagnosis of PE, death and major bleeding occur more frequently than recurrent VTE. Patients with systolic arterial hypotension and immobilization at the time of PE diagnosis had an increased isk of short-term mortality.