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Pulmonary Vascular Disease |

Long-term Outcome of Acute Pulmonary Embolism FREE TO VIEW

Hernando Chávez Roldán, MD; Jacinto Hernández Borge, MD; María del Carmen García García, MD; Pedro Pires Goncalves, MD; María Teresa Gómez Vizcaíno, MD; Amparo Sanz Cabrera, MD; María José Antona Rodríguez, MD; Pilar Cordero Montero, MD; Ana Castañar Jover, MD; Ignacio Rodríguez Blanco, MD
Author and Funding Information

Respiratory Disease Service, Hospital Infanta Cristina, Badajoz, Spain


Chest. 2014;145(3_MeetingAbstracts):528A. doi:10.1378/chest.1802214
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Abstract

SESSION TITLE: DVT/PE Posters

SESSION TYPE: Poster Presentations

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

PURPOSE: Our goal has been to study long-term survival and main causes of mortality in patients with acute pulmonary embolism (APE).

METHODS: Observational study of a cohort of patients consecutively admitted to our department with APE. Patients were followed until October 2012. We collected socio-demographic variables, complementary studies, complications during treatment, length of anticoagulant therapy and cause of death. Variables associated with mortality in univariate analysis were included in a Cox proportion hazard modeling.

RESULTS: Two hundred and thirteen patients (56,8% men, average age 62,3 ± 16,6 years) were included. 25% of the patients had not predisposing risk factors and 15% had a previous venous thrombosis (VT). ICU admission was required in 27,2% and 20,7% had complications during treatment. The average follow-up was 22,5 ± 17,5 months and the average length of treatment was 20,2 ± 17,5 months. At the end of the follow-up mortality was 16% (5,6% recurrent APE, 7,5% cancer and 2,8% others). Risk factors for death were male sex, malignancy, presence of predisposing risk factors and clinical absence of VT. Comorbidities, clinical presentation, angio-CT severity, echocardiographic or leg-ultrasonograhy abnormalities were not risk factors for mortality. Multivariate analysis showed that malignancy (OR 3,3; 95% CI 1,6 - 6,1) and presence of predisposing risk factors (OR 4,6; 95% CI 1,05 - 19, 6) were independently associated with higher mortality.

CONCLUSIONS: 1.- In our experience, long-term mortality after APE was 16%. 2.- Predisposing risk factors and malignancies were risk factors for mortality but were not related to hemodynamic severity of APE.

CLINICAL IMPLICATIONS: According to different studies mortality in patients with acute pulmonary embolism (APE) ranges between 1,4 and 17,4% at 3 months. This variability shows the clinical and prognostic heterogeneity of these patients. Complications associated with APE and recurrences are the main causes of early mortality while comorbidities are the cause of late mortality.

DISCLOSURE: The following authors have nothing to disclose: Hernando Chávez Roldán, Jacinto Hernández Borge, María del Carmen García García, Pedro Pires Goncalves, María Teresa Gómez Vizcaíno, Amparo Sanz Cabrera, María José Antona Rodríguez, Pilar Cordero Montero, Ana Castañar Jover, Ignacio Rodríguez Blanco

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