To identify independent predictors for in-hospital events across acute Pulmonary Embolism (PE).
135 consecutive patients admitted for PE. The primary endpoint was a composite of in-hospital mortality and the need for escalation of treatment defined by one of the following: infusion of catecholamine, endotracheal intubation or cardiopulmonary resuscitation.
Mean age of the population was 60.7 ± 18.5 years with a female predominance (57.8%). Ten percent presented in cardiogenic shock, with a 5% rate of mechanical ventilation. Almost 60% of patients had markers of RV dysfunction or injury. Fibrinolysis with alteplase was performed in 84.4% of the population. Classic heparin was the anticoagulant preferred for 37.0 % of the population, low molecular weight heparin was used in 19.6% and both were prescribed during the admission for 33.6% of the patients. The majority (80.4%) were started on oral antiocoagulation during the first 48 hours. The in-hospital death rate was 8.1% and a bleeding episode was detected in 17% of patients. Eleven percent of the population had the primary endpoint of this analysis. On a multivariate regression logistic analysis we identified three independent predictors for the endpoint: age > 73 years (OR 6.8, 95%CI 1.7 –26.8), admission glycemia > 249 mg/dL (OR 5.5, 95% CI 1.1 –26.8) and male gender (OR 0.1, 95% CI 0.01 –0.53).
In our population, in-hospital outcome could be predicted using simple features, signaling that is easy to identify the high risk subgroup of “real world” PE patients.
Local data of a disease that is poorly represented across randomized clinical trials.
Rogerio Teixeira, No Financial Disclosure Information; No Product/Research Disclosure Information