Involvement of the iliocaval venous axis was an independent predictor of in-hospital mortality in patients admitted for pulmonary embolism (present in 18.8% of non-survivors vs 6.6% of survivors, P=0.011).
Cohort (n=530)
No
Does the presence and location of DVT predict in-hospital mortality in patients admitted for pulmonary embolism?
In patients admitted for pulmonary embolism, concomitant deep vein thrombosis involving the iliocaval venous axis is an independent predictor of in-hospital mortality and may aid in prognostic stratification.
p-value: p=0.011
BACKGROUND: Pulmonary embolism (PE) is one of the most common causes of death from cardiovascular disease. Although deep vein thrombosis (DVT) is the leading cause of PE, its prognostic role is unclear. This study investigated the incidence and prognostic value of DVT in predicting in-hospital mortality (IHM) in patients admitted from the emergency department (ED) for PE. METHODS: This retrospective cohort study was conducted in the ED of a third-level university hospital. Patients over 18 years admitted for PE between 1 January 2018 and 31 December 2022 were included. RESULTS: Five hundred and thirty patients (mean age 73.13 years, 6% IHM) were included. 69.1% of cases had DVT (36.4% unilateral femoral vein, 3.6% bilateral, 39.1% unilateral popliteal vein, 2.8% bilateral, 45.7% distal vein thrombosis and 7.4% iliocaval involvement). Patients who died in hospital had a higher Pulmonary Embolism Severity Index (PESI) (138.6 vs. 99.65, p II, right ventricular dysfunction, increased blood markers of myocardial damage and involvement of the iliocaval venous axis were independent predictors of IHM on multivariate analysis. CONCLUSIONS: Although further studies are needed to confirm the prognostic role of DVT at PE, involvement of the iliocaval venous axis should considered to be a sign of a higher risk of IHM and may be a key factor in prognostic stratification.
Pagano et al. (Tue,) conducted a cohort in Pulmonary embolism (n=530). Deep vein thrombosis (specifically iliocaval venous axis involvement) vs. No deep vein thrombosis / no iliocaval involvement was evaluated on In-hospital mortality (IHM) (p=0.011). Involvement of the iliocaval venous axis was an independent predictor of in-hospital mortality in patients admitted for pulmonary embolism (present in 18.8% of non-survivors vs 6.6% of survivors, P=0.011).