Pulmonary embolism: Association between deep vein thrombosis, clinical profile and long-term outcome - 05/01/18
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Résumé |
Background |
Although considered as the main cause of pulmonary embolism (PE), deep vein thrombosis (DVT) is not always diagnosed during an episode of pulmonary embolism.
Aim |
In a cohort of patients with acute PE, this study compared baseline clinical data and long-term prognosis according to the presence of concomitant DVT.
Methods |
We conducted a longitudinal, observational, retrospective study in Limoges University Hospital Center. We included patients>60years old with a first symptomatic episode of PE who underwent a lower extremities Duplex ultrasonography looking for DVT. The primary combined end-point was mortality and recurrent venous thromboembolic events.
Results |
A total of 296 patients were included of whom 122 (41%) males with mean age 75.9±7.9years. The presence of DVT was found in 169 (57%) cases and isolated superficial vein thrombosis in 6 (2%) cases. Compared to those with DVT, patients without DVT had significantly more frequently myocardial infarction within previous 3 months (2.4% vs. 0%, P=0.045), hip or knee replacement (5.5% vs. 1.2%, P=0032), and other recent surgery (3.1% vs. 0%, P=0.020) and less chemotherapy (2.4% vs. 9.5%, P=0.014). During a mean follow-up of 4.3±3.5years, 153 (51.7%) deaths occurred and 26 (8.8%) recurrent venous thromboembolic events. Patients with DVT did not have higher mortality or recurrence of venous thromboembolism compared with patients without DVT both at 1- and 8-year (77±3% vs. 82±4%; 37±4% vs. 38±5%, P=0.244 and P=0.561, respectively). Patients with DVT had a significantly higher 30-day mortality compared with patients without DVT (91±2% vs. 98±1% P=0.031). This result remained significant after adjustment for age and predisposing factors of venous thromboembolism responsible of medical and surgical immobilization.
Conclusion |
Apart from some clinical differences and a worse short term prognosis, concomitant DVT with PE is not associated with increased long-term risk of thromboembolism and mortality.
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Vol 10 - N° 1
P. 104-105 - janvier 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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