Pulmonary Vascular Disease |

Pulmonary Embolism in the Elderly FREE TO VIEW

Pedro Pires Goncalves, MD; Jacinto Hernández Borge, MD; María del Carmen García García, MD; Hernando Chávez Roldán, MD; José Antonio Gutierrez Lara, MD; María José Antona Rodríguez, MD; Amparo Sanz Cabrera, MD; Francisca Lourdes Márquez Pérez, MD; Pilar Cordero Montero, MD; Ignacio Rodríguez Blanco, MD
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Respiratory Disease Service, Hospital Infanta Cristina, Badajoz, Spain

Chest. 2014;145(3_MeetingAbstracts):529A. doi:10.1378/chest.1802176
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SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: To analyze the characteristics of patients admitted for acute pulmonary thromboembolism (PE) and identify whether there are differences in presentation, severity and outcome at discharge of elderly patients (> 75 years) comparing to the younger patients.

METHODS: Retrospective review of 213 patients admitted to our department with PE. We established two groups: A (age ≥ 75 years) and B (age <75) and collected risk factors, associated diseases, symptoms, diagnostic techniques and their results, and in-hospital mortality and complications. The analysis was performed using SPSS v 15.

RESULTS: 62 patients were included in group A (54,8% female) and 151 in group B (38,4% female). Presence of heart disease (38,7% in A vs 12,6% in B, p < 0,005), diabetes (16,15 in A vs 6,6% in B, p = 0,003) and hypertension (62,9% in A vs 32,5% in B, p < 0,005) was more frequent in group A. Idiopathic PE was less frequent among these patients (19,4% in A vs 32,5% in B, p = 0,005). There were no differences in diagnostic delay (8,7 ± 16 days in A vs. 8,29 ± 10 days in B) or in the level of dyspnea. In group A it was more frequent the presence of syncope (25,8% in A vs 13,9% in B, p = 0,047) and less frequent the pulmonary infarction (21% in A vs 34,4% in B, p = 0,07). We did not find differences in EKG, Chest X-Ray or leg ultrasonography abnormalities. The PE severity on CT angiogram was higher in group B (massive or submassive PE: 61,7% in B vs 53,2% in A, p = 0,019, involvement of pulmonary trunk or main branches: 70,3% in B vs 55,8% in A, p = 0,08), although echocardiography abnormalities were lower (43,45 in B vs 57,1% in A, p = 0,1). There were no significant differences regarding the occurrence of complications (A: 21% vs B: 18,6%) although ICU admission was more frequent in group B (31,8% in B vs 16% in A; p < 0,05). In-hospital mortality was higher in group A (4,8% in A vs 1,32% in B, p = NS).

CONCLUSIONS: 1.- Comorbidities are more common in elderly patients with PE. 2.- Syncope was more frequent in these patients despite less angiographic impairment. 3.- In-hospital mortality was higher in these patients although treatment and complications were similar in both groups.

CLINICAL IMPLICATIONS: Acute pulmonary thromboembolism (PE) is a frecuent disease, potentially lethal and difficult to diagnose.

DISCLOSURE: The following authors have nothing to disclose: Pedro Pires Goncalves, Jacinto Hernández Borge, María del Carmen García García, Hernando Chávez Roldán, José Antonio Gutierrez Lara, María José Antona Rodríguez, Amparo Sanz Cabrera, Francisca Lourdes Márquez Pérez, Pilar Cordero Montero, Ignacio Rodríguez Blanco

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