Clinical Presentation and Outcome of Acute Pulmonary Embolism in Emergency Department, University Hospital, Northeast, Thailand

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Kamonwon Ienghong
Chitchanok Piensee
Korakot Apiratwarakul
Praew Kotruchin
Wutchara Ruttanaseha
Pariwat Phungoen

Abstract

Background and objective: The incidence of acute pulmonary embdism (APE) in Thailand are unknown. With new diagnostic tools and current advanced knowledge, APE was discovered to be much more frequent in Thailand than earlier believed.  Clinical outcome of APE had not been previously firmly identified. The aim of this study was to evaluation signs, symptoms, laboratory data, treatments and outcomes of patients diagnosed with APE in emergency department (ED).


Methods: The study design was retrospective descriptive study. We searched electronic databases (Jan. 2008 – Nov. 2018) for patients with suspected APE and diagnosed by computed tomographic pulmonary angiography (CTPA) in Srinagarind hospital.


Results: A total of 110 patients with confirmed APE was enrolled from ED. 67 patients were female (60.91%). The age of patients varied from 22 to 91 years old. The mean age was 62.4 years old. Malignancy was the most frequent co-morbidity (48.18%). The most common presenting symptoms and signs were dyspnea (86.36%), followed by tachypnea (66.36%) and tachycardia (50.91%). The most frequent radiographic abnormalities were pulmonary parenchymal lesions (40.91%). Most electrocardiograms were sinus tachycardia (50%). Echocardiography findings were RV dilatation in most cases (48.44%). D-dimer, Troponin-T and NT pro-BNP were increased in patients with APE. The mortality rate at the hospital admission was 5 in 110 patients (4.55%).


Conclusion: The most common clinical characteristics of APE patients in ED were dyspnea similar to previous reports in other countries. The mortality rate showed no difference when compared to previous studies.

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