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September 14, 2020Open Access

Thrombolysis in Acute Pulmonary Embolism: are we over – doing it?

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Why the study?

The authors aimed to study clinical data and outcomes of patients admitted with acute PE over a five-year period.

Does systemic thrombolysis improve outcomes or increase bleeding in patients with acute pulmonary embolism?

Population

114 patients admitted with acute PE at a tertiary centre in South India

Comparison

Central PE vs peripheral PE, and thrombolysed vs non-thrombolysed patients

Design

Retrospective single-centre study

Follow-up

90 days

Authors

RSRefai ShowkathaliApollo HospitalsRYRadhapriya YalamanchiApollo HospitalsRBR. BalasubramaniamCancer Institute (WIA)

Discussion

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Implication

Highlights the severe bleeding trade-off for off-guideline thrombolysis in acute pulmonary embolism.

Structured PICO

Does systemic thrombolysis improve outcomes or increase bleeding in patients with acute pulmonary embolism?

P
Population
114 patients (69 male, 55 female) admitted with acute pulmonary embolism (82 central PE, 32 peripheral PE), mean age 55 +/- 15 years, at a tertiary centre in South India.
I
Intervention
Systemic thrombolysis
C
Comparator
No systemic thrombolysis
O
Outcome
In-hospital bleeding, in-hospital RV function improvement, PAH improvement, duration of hospital stay, 30 and 90 day mortality

Non-guideline-directed use of systemic thrombolysis in acute pulmonary embolism is associated with a significantly increased risk of bleeding.

Cite This Study

Showkathali et al. (2020) studied this question.

synapsesocial.com/papers/6a892cae3aa2d8278f761274https://doi.org/10.1101/2020.09.13.20193672
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Clinical Course of Pulmonary Embolism1992 · 1,047 citations
  2. 2Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients With Acute Symptomatic Pulmonary Embolism2010 · 1,363 citations
  3. 3Guidelines on the diagnosis and management of acute pulmonary embolism2008 · 2,835 citations
  4. 4Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism2017 · 363 citations