Differences in clinical presentation of pulmonary embolism in older vs younger patients
Circulation Journal, cilt.69, sa.8, ss.981-986, 2005 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 69 Sayı: 8
- Basım Tarihi: 2005
- Doi Numarası: 10.1253/circj.69.981
- Dergi Adı: Circulation Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.981-986
- Anahtar Kelimeler: elderly, pulmonary embolism, pulmonary vascular obstruction score (PVOs), RISK-FACTORS, THROMBOSIS, THROMBOEMBOLISM, DIAGNOSIS
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Gazi Üniversitesi Adresli: Evet
Özet
Background: In order to better define the clinical characterization of pulmonary embolism (PE) in the elderly, the clinical and laboratory findings were compared in older (≥65 years old) and younger (<65 years old) patients. Methods and Results: The study group comprised 149 patients (58 older and 91 younger) who received a final diagnosis of PE and were retrospectively evaluated. The severity of PE was assessed by calculating the pulmonary vascular obstruction scores (PVOs) scintigraphically: PVOs ≥50% was defined as severe disease. Dyspnea was the most frequent symptom in both groups. Chest pain and hemoptysis were less frequent in older patients (48.3% vs 79.1%, p=0.001; 6.9% vs 20.9%, p=0.021, respectively) whereas syncope occurred more often in the older group (27.6% vs 9.9%, p=0.005). PVOs ≥50% occurred in 55.1% of older and 32.9% of younger patients (odds ratio: 1.67, 95%confidence interval: 1.118-2.507, p=0.013). Conclusions: The clinical presentation of PE can be subtle or atypical in elderly patients and hence they may have more severe disease. Therefore, a high clinical suspicion is required in order to prevent delays in diagnostic work-up and initiation of appropriate treatment.