engleski

The epidemiology and a six-year experience in treatment of pulmonary embolism in University hospital

Aim. Pulmonary embolism (PE) is one of the major cardiovascular diseases encountered by the ICU physicians. Evaluation of the demography and the main clinical characteristics of patients treated for the PE provides the useful data on predisposing conditions in one's own population as well as the ICU’ s performance in early diagnosis and successful treatment of the disease. Patients and methods. During the six-year period, from January 2000 to December 2005, all of the medical records of patients treated for PE in the Medical ICU at the University Hospital Sestre Milosrdnice, Zagreb, Croatia, were retrospectively analysed. The diagnosis was based on clinical presentation, ECG, positive D-dimers, right ventricular dysfunction found on echocardiogram and positive ventilation - perfusion (V/Q) lung scan or multidetector computed tomography (MDCT). Results. The analysis comprised of 165 patients ; age median was 73 years (range 21-91 years). Seventy percent of them were female patients. The dominant symptom was dyspnea (97.0%) and the most common sign was tachypnea (69.6%). Deep vein thrombosis was found in 39.4% of the patients. Twenty percent (33 patients) had no evident predisposition for developing PE. Of 56 patients admitted from other wards (medical or surgical), 59% received the LMWH prophilaxis but still developed the PE. The PE was regarded as massive in 63 (38.2%), submassive in 23 (13.9%) and small in 79 patients (47.9%). The overall ICU mortality was 26.7%, the highest rate being in patients with massive PE (20%). There was not statistically significant difference between mortality of male and female patients. The mean ICU length of stay was 7.1+/-4.4 days. Conclusion. Pulmonary embolism remains an important clinical problem with high mortality rate. Identifying high risk patients and proper deep vein thrombosis prophilaxis may help preventing the unfavourable outcome.

pulmonary embolism; demography; diagnosis; mortality

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