Key result
Older patients (≥65 years) with pulmonary embolism had a higher rate of severe disease compared to younger patients (55.1% vs 32.9%; OR 1.67; 95% CI 1.118-2.507; p=0.013).
Why the study?
Do clinical presentation and severity of pulmonary embolism differ between older (≥ 65 years) and younger (< 65 years) patients?
Observational (n=149)
Do clinical presentation and severity of pulmonary embolism differ between older (≥ 65 years) and younger (< 65 years) patients?
Effect estimate: OR 1.67 (95% CI 1.118-2.507)
Absolute Event Rate: 55.1% vs 32.9%
p-value: p=0.013
Elderly patients with pulmonary embolism often present with atypical symptoms like syncope rather than chest pain or hemoptysis, and tend to have more severe disease, requiring high clinical suspicion.
Supports closer monitoring for severe PE in older adults; leaves open whether age-adjusted thresholds improve risk stratification.
BACKGROUND: In order to better define the clinical characterization of pulmonary embolism (PE) in the elderly, the clinical and laboratory findings were compared in older (> or = 65 years old) and younger (< 65 years old) patients. METHODS AND RESULTS: The study group comprised 149 patients (58 older and 91 younger) who received a final diagnosis of PE and were retrospectively evaluated. The severity of PE was assessed by calculating the pulmonary vascular obstruction scores (PVOs) scintigraphically: PVOs > or = 50% was defined as severe disease. Dyspnea was the most frequent symptom in both groups. Chest pain and hemoptysis were less frequent in older patients (48.3% vs 79.1%, p = 0.001; 6.9% vs 20.9%, p = 0.021, respectively) whereas syncope occurred more often in the older group (27.6% vs 9.9%, p = 0.005). PVOs > or = 50% occurred in 55.1% of older and 32.9% of younger patients (odds ratio: 1.67, 95%confidence interval: 1.118-2.507, p = 0.013). CONCLUSIONS: The clinical presentation of PE can be subtle or atypical in elderly patients and hence they may have more severe disease. Therefore, a high clinical suspicion is required in order to prevent delays in diagnostic work-up and initiation of appropriate treatment.
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Köktürk et al. (2005) conducted an observational in Pulmonary embolism (n=149). Older age (≥ 65 years) vs. Younger age (< 65 years) was evaluated on Severe disease (pulmonary vascular obstruction scores ≥ 50%) (OR 1.67, 95% CI 1.118-2.507, p=0.013). Older patients (≥65 years) with pulmonary embolism had a higher rate of severe disease compared to younger patients (55.1% vs 32.9%; OR 1.67; 95% CI 1.118-2.507; p=0.013).
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