Unprovoked pulmonary embolism in older adults: incidence and prognosis

Q: What are the key findings of this study?

Unprovoked pulmonary embolism in older adults was associated with a significantly lower 1-year mortality rate (11.1%) compared to provoked pulmonary embolism (26.5%) and malignancy-associated pulmonary embolism (76.5%).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Pulmonary embolism (n=249). Intervention: Unprovoked pulmonary embolism vs. Provoked pulmonary embolism. Primary outcome: 1-year all-cause mortality (p=<0.05).

Mor Aharoni; Nir Horesh; Ori Rogowski; Anjelika Kremer; Haim Mayan; Dan Justo

doi:10.5114/aoms/90673

March 1, 2021Archives of Medical ScienceOpen Access

Unprovoked pulmonary embolism in older adults: incidence and prognosis

View Full Paper

Ask AI

Bookmark

Share

Key result

Unprovoked PE in older adults is linked to ~58% lower 1-year mortality versus provoked PE.

P<0.05
n=249

Figures

Why the study?

Unprovoked pulmonary embolism carries an unfavorable prognosis in adults, but its incidence and prognosis in older adults had never been studied.

Does unprovoked pulmonary embolism affect mortality compared to provoked or malignancy-associated pulmonary embolism in older adults?

Study Design

Type

Cohort (n=249)

Multicenter

No

Structured PICO

Does unprovoked pulmonary embolism affect mortality compared to provoked or malignancy-associated pulmonary embolism in older adults?

P

Population

Older adults (aged 70 years or more) with unprovoked pulmonary embolism (UPE), provoked pulmonary embolism (PPE), and malignancy-associated PE (MAPE), admitted to a tertiary medical center between 2010 and 2012.

I

Intervention

Unprovoked pulmonary embolism (UPE)

C

Comparator

Provoked pulmonary embolism (PPE) and malignancy-associated PE (MAPE)

O

Outcome

All-cause 3-year mortality rates and cumulative survival following admissionhard clinical

Main Result

Absolute Event Rate: 11.1% vs 26.5%

p-value: p=<0.05

In older adults, unprovoked pulmonary embolism is associated with a favorable prognosis within 1 year of admission compared to other types of PE.

Limitations

Small sample size
Observational nature of the study
Lack of information concerning the anticoagulation therapy duration following discharge
Lack of an inherited thrombophilia workup in most UPE patients
Lack of an occult malignancy workup in all UPE patients
Lack of information concerning how massive the PE was in terms of right heart failure
Lack of information concerning the actual cause of death and PE-related deaths rather than an all-cause mortality

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

May refine prognosis discussions in older adults with PE; leaves open whether etiology should guide management.

Abstract

INTRODUCTION: Unprovoked pulmonary embolism (UPE) is not rare and it is associated with an unfavorable prognosis in adults. However, the incidence and the prognosis of UPE in older adults have never been studied. MATERIAL AND METHODS: This was a historical prospective study. We reviewed all the medical charts of all older adults (aged 70 years or more) with UPE, provoked pulmonary embolism (PPE), and malignancy-associated PE (MAPE), admitted to a tertiary medical center between 2010 and 2012. The all-cause 3-year mortality rates and cumulative survival following admission were compared between the groups. CONCLUSIONS: UPE is not rare in older adults with PE, and it is associated with a favorable prognosis within 1 year of admission in this population.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Aharoni et al. (2021) conducted a cohort in Pulmonary embolism (n=249). Unprovoked pulmonary embolism vs. Provoked pulmonary embolism was evaluated on 1-year all-cause mortality (p=<0.05). Unprovoked pulmonary embolism in older adults was associated with a significantly lower 1-year mortality rate (11.1%) compared to provoked pulmonary embolism (26.5%) and malignancy-associated pulmonary embolism (76.5%).

synapsesocial.com/papers/6a06d24a6b3d000707583733 https://doi.org/10.5114/aoms/90673

View Full Paper

Ask AI

Bookmark

Share

Unprovoked pulmonary embolism in older adults: incidence and prognosis

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Unprovoked pulmonary embolism in older adults: incidence and prognosis

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading