What question did this study set out to answer?

To evaluate whether initial clinical risk stratification of acute pulmonary embolism predicts long-term all-cause mortality.

December 17, 2019Vascular MedicineOpen Access

Long-term mortality after massive, submassive, and low-risk pulmonary embolism

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Why the study?

Guidelines emphasize risk stratification using RV size and biomarkers in normotensive acute PE, but the prognostic importance of these factors on long-term mortality is unknown.

Does the severity of initial acute pulmonary embolism presentation predict long-term all-cause mortality?

Population

183 subjects diagnosed with acute PE at a tertiary care academic medical center

Comparison

Massive vs submassive vs low-risk initial PE presentation

Design

Retrospective cohort study

Follow-up

Median 4.1 years

Authors

RGRajesh GuptaUniversity of Toledo ZAZaid AmmariChristiana Care Health System ODOsama DasaUniversity of Florida

Discussion

Member takes

Implication

Initial PE severity stratifies long-term mortality differences; leaves open whether RV parameters add prognostic value beyond presentation.

Key Points

To evaluate whether initial clinical risk stratification of acute pulmonary embolism predicts long-term all-cause mortality.
Retrospective cohort study of 183 adults diagnosed with acute pulmonary embolism between 2010 and 2015 at a tertiary care academic medical center, followed for a median of 4.1 years.
Severity was stratified into massive, submassive, and low-risk pulmonary embolism, with all-cause mortality assessed via the National Death Index.
All-cause mortality was 7.7% at 30 days and 40.4% overall, with mortality rates of 71.4% for massive, 44.5% for submassive, and 28.1% for low-risk pulmonary embolism (p < 0.001).
A 30-day landmark analysis showed that submassive pulmonary embolism conferred higher mortality than low-risk presentations in both short- and long-term periods.
Independent predictors of all-cause mortality included initial presentation with massive pulmonary embolism, baseline cancer, older age, elevated white blood cell count, diabetes, liver disease, and female sex.

Structured PICO

Does the severity of initial acute pulmonary embolism presentation predict long-term all-cause mortality?

Population

183 subjects diagnosed with acute pulmonary embolism (PE) from 2010 to 2015 at a tertiary care academic medical center, median age 65 years.

Intervention

Initial PE presentation categorized as massive, submassive, or low-risk

Comparator

Comparison among massive, submassive, and low-risk PE groups

Outcome

All-cause mortality ascertained using the Centers for Disease Control National Death Index (CDC NDI)hard clinical

The severity of initial acute pulmonary embolism presentation is significantly associated with both short- and long-term all-cause mortality.

Cite This Study

Gupta et al. (2019) studied this question.

synapsesocial.com/papers/6a7272e7f44fa9f079dfeec3 https://doi.org/10.1177/1358863x19886374

Topics

Pulmonary embolism

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Implication

Initial PE severity stratifies long-term mortality differences; leaves open whether RV parameters add prognostic value beyond presentation.

Long-term mortality after massive, submassive, and low-risk pulmonary embolism

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Long-term mortality after massive, submassive, and low-risk pulmonary embolism

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider