DOI: http://dx.doi.org/10.18203/2349-3933.ijam20192599

Clinical profile of patients of acute pulmonary thromboembolism

Arundhati Diwan, Supriya Barsode, Chandrakant Chavan, Rohit Jakhotia, Krishnapriya Vadlapatla

Abstract


Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.

Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.

Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..

Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.


Keywords


Anticoagulation, CTPA, Pulmonary embolism, Thrombolysis, 2D ECHO

Full Text:

PDF

References


Saeger W, Genzkow M. Venous thromboses and pulmonary embolisms in post-mortem series: probable causes by correlations of clinical data and basic diseases. Pathol Res Pract. 1994;190(4):394-9.

Ozsu S, Oztuna F, Bulbul Y. The role of risk factors in delayed diagnosis of pulmonary embolism. Am J Emerg Med. Jan 2011;29(1):26-32.

Tapson VF. Acute pulmonary embolism. N Engl J Med. 2008;358(10):1037-52.

Agarwal R, Gulati1 M, Mittal BR, Jindal SK. Clinical Profile, Diagnosis and Management of Patients Presenting with Symptomatic Pulmonary Embolism. Ind J Chest Dis Allied Sci. 2006;48:110-4.

Miniati M, Cenci C, Monti S, Poli D. Clinical presentation of acute pulmonary embolism: survey of 800 Cases. PLoS ONE. 2012;7(2):e30891.

Becattini C, Agnelli G, Prandoni P, Silingardi M, Salvi R, Taliani MR, et al. A prospective study on cardiovascular events after acute pulmonary embolism. Eur Heart J. 2005;26(1):77-83.

Pinjala R. Venous thromboembolism risk & prophylaxis in the acute hospital care setting (ENDORSE), a multinational cross-sectional study: Results from the Indian subset data. Indian J Med Res. 2012;136(1):60-7.

Sharma SK, Gupta V, Kadhiravan T, Banga A, Seith A, Kumar A, et al. A prospective study of risk factor profile & incidence of deep venous thrombosis among medically-ill hospitalized patients at a tertiary care hospital in northern India. Indian J Med Res. 2009;130(6):726-30.

Sen RK, Kumar A, Tripathy SK, Aggarwal S, Khandelwal N, Manoharan SR. Risk of postoperative venous thromboembolism in Indian patients sustaining pelvi-acetabular injury. Int Orthop. 2011 Jul 1;35(7):1057-63.

Tillie-Leblond I, Marquette CH, Perez T, Scherpereel A, Zanetti C, Tonnel AB, et al. Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. Ann Intern Med. 2006;144(6):390-6.

Sawant SP, Banumathy S, Daddi A, Dhir AA. Pulmonary embolism in cancer patients. Indian J Cancer. 2012 Jan 1;49(1):119-24.

Lolly M, Patil BB, Eti A, Sujay J, Khan S, Bansal A. Clinical profile of patients presenting with acute pulmonary thromboembolism in a tertiary care hospital in India: A retrospective study. J NTR Univ Health Sci. 2017;6(1):15-8.

Bhardwaj R, Sarkar M. Thrombolysis in angiographically proved intermediate to high risk pulmonary embolism. J Asso Physicians India. 2018;66:18-20.

Stein PD, Beemath A, Matta F, Weg JG, Yusen RD, Hales CA, et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med. 2007;120(10):871-9.

Klok FA, Mos ICM, Tamsma JT, van Kralingen KW, Huisman MV. Smoking patterns in patients following a pulmonary embolism. Eur Resp J. 2009;33(4):942-3.

Cheng YJ, Liu ZH, Yao FJ, Zeng WT, Zheng DD, Dong YG, et al. Current and former smoking and risk for venous thromboembolism: a systematic review and meta-analysis. PloS Med. 2013;10:1-14.

Posadas-Martínez ML, Vázquez FJ, Giunta DH, Waisman GD, de Quirós FG, Gándara E. Performance of the Wells score in patients with suspected pulmonary embolism during hospitalization: a delayed-type cross sectional study in a community hospital. Thromb Res. 2014;133(2):177-81.

Wang JH, Christino MA, Thakur NA, Palumbo MA, Daniels AH. Evaluation of the utility of the Wells score in predicting pulmonary embolism in patients admitted to a spine surgery service. Hosp Pract. 2013;41(1):122-8.

Youssf AR, Ismail MF, ElGhamry R, Reyad MR. Diagnostic accuracy of D-dimer assay in suspected pulmonary embolism patients. Egyptian Journal of Chest Diseases and Tuberculosis. 2014;63(2):411-7.

Chopra N, Doddamreddy P, Grewal H, Kumar PC. An elevated D-dimer value: a burden on our patients and hospitals. Int J General Med. 2012;5:87-92.

Perrier A, Desmarais S, Goehring C, de Moerloose PH, Morabia A, Unger PF, et al. D-dimer testing for suspected pulmonary embolism in outpatients. Am J Resp Crit Care Med. 1997;156(2):492-6.

Elliott CG, Goldhaber SZ, Visani L, DeRosa M. Chest radiographs in acute pulmonary embolism. Results from the International Cooperative Pulmonary Embolism Registry. Chest. 2000;118(1):33-8.

Wan S, Quinlan DJ, Agnelli G, Eikelboom JW. Thrombolysis compared with heparin for the initial treatment of pulmonary embolism: a meta-analysis of the randomized controlled trials. Circulation. 2004;110(6):744-9.

Goldhaber SZ, Visani L, De Rosa M. acute pulmonary embolism: clinical outcomes in the international cooperative pulmonary embolism registry (ICOPER). Lancet. 1999;353(9162):1386-9.

Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, et al. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation. 2000. 20;101(24):2817-22.