In-hospital onset of acute massive or submassive pulmonary embolism was associated with a lower recurrence rate compared to out-of-hospital onset (0% vs 23%, p=0.03).
Cohort (n=56)
Absolute Event Rate: 0% vs 23%
p-value: p=0.03
BACKGROUND: Acute massive or submassive pulmonary embolism (PE) has high mortality, but the clinical course according to the location of onset (ie, in-hospital or out-of-hospital) is unknown. METHODS AND RESULTS: In the present study 56 consecutive patients with acute massive or submassive PE were studied retrospectively and a comparison made of the clinical characteristics, and outcomes between in-hospital onset (Group A) and out-of-hospital onset (Group B). Patients in Group A (n=28) had more frequent comorbidities with hemodynamic instability (54% vs 4%, p<0.0001) and temporary risk factors (93% vs 11%, p<0.0001), whereas patients in Group B (n=28) had a longer duration of symptoms (median: 5.5 days vs 0.5 day; p<0.0001), and had higher systolic pulmonary artery pressure (63+/-17 mmHg vs 46+/-12 mmHg, p=0.0006). Although in-hospital mortality did not differ between the 2 groups, the recurrence rate was higher in Group B (23% vs 0%, p=0.03). CONCLUSIONS: Patients who had in-hospital onset of PE had mostly temporary risk factors, unstable hemodynamics and a lower recurrence rate compared with the cases of out-of-hospital onset. In cases of in-hospital onset, prompt diagnosis and suitable treatment is needed to prevent fatalities and cases of out-of-hospital onset should be followed carefully for recurrence.
Yamamoto et al. (Thu,) conducted a cohort in Acute massive or submassive pulmonary embolism (n=56). In-hospital onset vs. Out-of-hospital onset was evaluated on Recurrence rate (p=0.03). In-hospital onset of acute massive or submassive pulmonary embolism was associated with a lower recurrence rate compared to out-of-hospital onset (0% vs 23%, p=0.03).
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