Cadena NB, Pelayo TEF, Treviño FR, Dávila BA, Ponce LE, García SR, Guerra VMN

Language: English
References: 10
Page: 116-122
PDF size: 215.22 Kb.

ABSTRACT

Introduction: Pulmonary thromboembolism (PTE) is a cardiovascular emergency threatening life. It is classified at low, intermediate and high risk of mortality. By the above, it allows to establishing conservative treatment for low-intermediate risk PTE and more intense treatment for high risk PTE. Objective: To report the number of cases of acute PTE, risk stratification and prognosis in those treated with adherence to clinical guidelines. Material and methods: Review of clinical records with a diagnosis of acute PTE by confirmatory diagnostic test. The type of treatment was determined by: oral anticoagulation (OAC) or parenteral anticoagulation (PAC), percutaneous thrombectomy, supraselective thrombolysis, systemic thrombolysis, surgical thrombectomy or combinations. The type of initial anticoagulation and maintenance therapy. Hard results: TIMI major bleeding, re-thrombosis, death and brain stroke (BS). Normality was verified by Kolmogorov-Smirnov test. Then was compared with Student t or U Mann-Whitney. Results: A sample of 36 patients was obtained, the mean age was 67.24 ± 18.83 years, 62.2% were females. The 29.7% were low-risk PTE, 51.4% were intermediate risk and 18.9% were high risk. The 70.3% received OAC, 8.1% percutaneous trombectomy, 8.1% systemic thrombolysis, 10.8% systemic thrombolysis + percutaneous thrombolysis, 2.7% percutaneous trombectomy + supraselective thrombolysis. There is increased risk of death in this group OR = 2.63 (95% CI 0.45-16.08) but not significant (p = 0.255). Conclusions: Lack of adherence to clinical guidelines confers increased risk of death in patients with acute PTE, this difference is not statistically significant.

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