Contemporary Prospective Registry of Pulmonary Embolism Patients Presenting to a Large Tertiary Medical Center

Background:

Patients with pulmonary embolism (PE) represent a challenging group of patients. Currently there is lack of data regarding patients` course during hospitalization. We present the results of a large prospective registry of all venous thromboembolism (VTE) patients in a large tertiary medical center.

Methods:

Prospective registry of consecutive patients diagnosed with VTE at the Sheba medical center. We evaluated patients diagnosed with PE in regard to patient demographics, risk factors, presenting symptoms, imaging studies, treatment, in-hospital course, as well as post discharge treatment and outcome at 90-days.

Results:

From a total of 392 VTE patients, 326 PE patients were evaluated between 4/2016-9/2017. Mean patient age was 73±104 years, 43% were males. History of malignancy was present in 40%, and recent immobilization in 33% with the most common presenting symptom being dyspnea (76%), chest pain (22%), and pleuritic pain (21%). Using the current ESC criteria 6% were classified as high risk PE, 73% as intermediate risk, and 21% as low risk PE patients. In-hospital mortality was significantly higher in the high risk PE group (33%) when compared to intermediate (7%), and low risk (1.5%) PE groups (P<0.001). At 90 days adherence to the use of anticoagulation was high at 91%, with recurrent venous thromboembolism occurring in 5 patients (1.7%), Thrombophilia was diagnosed in 15 (5%), and malignancy was found in 10 (3.4%). At 90 day follow-up mortality was 33% in the high risk group, 25% in intermediate risk patients, and 3% in the low risk group.

Conclusions:

In contemporary practice, PE is a heterogeneous disease. While low risk PE patients have a relative benign course, both in-hospital and at follow-up, intermediate and high risk patients require close monitoring and demonstrate significant mortality both during hospitalization and at follow-up, respectively.