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Which patients with venous thromboembolism are at risk for fatal pulmonary embolism?

Authors
  • Gallus, Alexander
Type
Published Article
Journal
Nature Clinical Practice Cardiovascular Medicine
Publisher
Springer Nature
Publication Date
Oct 01, 2008
Volume
5
Issue
10
Pages
604–605
Identifiers
DOI: 10.1038/ncpcardio1308
PMID: 18679380
Source
Medline
License
Unknown

Abstract

In a registry of 15,520 patients treated for symptomatic deep vein thrombosis or pulmonary embolism (PE), the 90-day mortality was 8.65% and death was attributed to PE in 1.68% of patients (19.4% of all deaths). Multivariate analysis defined five simple predictors of death from PE during the first 3 months after presentation. The odds ratio for fatal PE was raised to 5.4 by initially nonmassive symptomatic PE (compared with deep vein thrombosis and no symptoms of PE), to 17.5 by initially massive PE (systolic blood pressure below 90 mmHg), 4.9 by immobility as a result of neurological disease, 2.5 by age over 75 years, and 2.0 by the presence of cancer. Of all the deaths from PE, 75% occurred within 12 days of presentation and 50% occurred within 5 days. These results reinforce previous observations that also linked symptomatic PE, massive PE, old age, and cancer to a raised likelihood of death from PE despite appropriate therapy.

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