Outcome of patients with different clinical presentations of high-risk pulmonary embolism

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Ebner , M , Sentler , C , Harjola , V-P , Bueno , H , Lerchbaumer , M H , Hasenfuss , G , Eckardt , K-U , Konstantinides , S & Lankeit , M 2021 , ' Outcome of patients with different clinical presentations of high-risk pulmonary embolism ' , European Heart Journal: Acute Cardiovascular Care , vol. 10 , no. 7 , pp. 787-796 . https://doi.org/10.1093/ehjacc/zuab038

Title: Outcome of patients with different clinical presentations of high-risk pulmonary embolism
Author: Ebner, Matthias; Sentler, Carmen; Harjola, Veli-Pekka; Bueno, Hector; Lerchbaumer, Markus H.; Hasenfuss, Gerd; Eckardt, Kai-Uwe; Konstantinides, Stavros; Lankeit, Mareike
Contributor organization: HUS Emergency Medicine and Services
Date: 2021-09
Language: eng
Number of pages: 10
Belongs to series: European Heart Journal: Acute Cardiovascular Care
ISSN: 2048-8726
DOI: https://doi.org/10.1093/ehjacc/zuab038
URI: http://hdl.handle.net/10138/337315
Abstract: Aims The 2019 European Society of Cardiology (ESC) guidelines provide a revised definition of high-risk pulmonary embolism (PE) encompassing three clinical presentations: Cardiac arrest, obstructive shock, and persistent hypotension. This study investigated the prognostic implications of this new definition. Methods and results Data from 784 consecutive PE patients prospectively enrolled in a single-centre registry were analysed. Study outcomes include an in-hospital adverse outcome (PE-related death or cardiopulmonary resuscitation) and in-hospital all-cause mortality. Overall, 86 patients (11.0%) presented with high-risk PE and more often had an adverse outcome (43.0%) compared to intermediate-high-risk patients (6.1%; P Conclusion The revised ESC 2019 guidelines definition of high-risk PE stratifies subgroups at different risk of in-hospital adverse outcomes and all-cause mortality. Risk prediction can be improved by using an optimised venous lactate cut-off value to diagnose obstructive shock, which might help to better assess the risk-to-benefit ratio of systemic thrombolysis in different subgroups of high-risk patients.
Subject: Pulmonary embolism
High risk
Lactate
Obstructive shock
Prognosis
PLASMA LACTATE LEVELS
EUROPEAN-SOCIETY
TASK-FORCE
MANAGEMENT
THROMBOEMBOLISM
STRATIFICATION
GUIDELINES
DIAGNOSIS
MORTALITY
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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