Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

61. Derivation and Validation of a Novel Prediction Model to Identify Low-Risk Patients With Acute Pulmonary Embolism

Derivation and Validation of a Novel Prediction Model to Identify Low-Risk Patients With Acute Pulmonary Embolism Accurate identification of low-risk patients with acute pulmonary embolism (PE) who may be eligible for outpatient treatment or early discharge can have substantial cost-saving benefit. The purpose of this study was to derive and validate a prediction model to effectively identify patients with PE at low risk of short-term mortality, right ventricular dysfunction, and other nonfatal

2017 EvidenceUpdates

62. Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism

Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months (...) of the 324 patients (10.5%) with residual pulmonary obstruction and in 15 out of the 323 patients (4.6%) without residual pulmonary obstruction, leading to an adjusted hazard ratio of 2.26 (95% CI 1.23-4.16).Residual pulmonary obstruction, as detected with perfusion lung scanning at 6 months after a first episode of pulmonary embolism, is an independent predictor of recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension.Copyright ©ERS 2017.

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2017 EvidenceUpdates

63. D-dimer Interval Likelihood Ratios for Pulmonary Embolism

D-dimer Interval Likelihood Ratios for Pulmonary Embolism The objective was to estimate D-dimer interval likelihood ratios (iLRs) for diagnosing pulmonary embolism (PE).The authors used pooled patient-level data from five PE diagnostic management studies to estimate iLRs for the eight D-dimer intervals with boundaries 250, 500, 750, 1,000, 1,500, 2,500, and 5,000 ng/mL. Logistic regression was used to fit the data so that an interval increase corresponds to increasing the likelihood ratio

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2017 EvidenceUpdates

64. CRACKCast E088 – Pulmonary Embolism & Deep Venous Thrombosis

CRACKCast E088 – Pulmonary Embolism & Deep Venous Thrombosis CRACKCast E088 - Pulmonary Embolism & Deep Venous Thrombosis - CanadiEM CRACKCast E088 – Pulmonary Embolism & Deep Venous Thrombosis In , by Adam Thomas June 29, 2017 This episode of CRACKCast covers Rosen’s Chapter 88, DVT and PE. This episode covers the risk factors, diagnostic approach, treatment and management of PEs and DVTs. Shownotes – Rosen’s in Perspective This chapter is all about VTE – venous thromboembolism (...) discussion) Fondaparinux Apixaban Rivaroxaban OR heparin infusion after a loading bolus Ideally transition to oral anticoagulation at least 3 months (some up to 12 months) Encourage ambulation as much as possible Bedrest promotes DVT extension, risk of embolization, and post-DVT syndrome 8) What are the common causes of upper limb DVT? Upper limb DVT = thrombosis in the axillary vein “ The deep veins of the upper extremity include the paired ulnar, radial and interosseous veins in the forearm, paired

2017 CandiEM

65. The Risk of Deep Venous Thrombosis and Pulmonary Embolism in Primary Sjogren Syndrome: A General Population-based Study

The Risk of Deep Venous Thrombosis and Pulmonary Embolism in Primary Sjogren Syndrome: A General Population-based Study To estimate the future risk and time trends of venous thromboembolism (VTE) in individuals with newly diagnosed primary Sjögren syndrome (pSS) in the general population.Using a population database that includes all residents of British Columbia, Canada, we created a study cohort of all patients with incident SS and up to 10 controls from the general population matched for age (...) , sex, and entry time. We compared incidence rates (IR) of pulmonary embolism (PE), deep vein thrombosis (DVT), and VTE between the 2 groups according to SS disease duration. We calculated HR, adjusting for confounders.Among 1175 incident pSS cases (mean age 56.7 yrs, 87.6% women), the IR of PE, DVT, and VTE were 3.9, 2.8, and 5.2 per 1000 person-years (PY), respectively; the corresponding rates in the comparison cohort were 0.9, 0.8, and 1.4 per 1000 PY. Compared with non-SS individuals

2017 EvidenceUpdates

66. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. (PubMed)

Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible (...) with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism.We did a prospective, multicentre, cohort study in 12 hospitals in the Netherlands, including consecutive patients with suspected pulmonary embolism between Oct 5, 2013, to July 9, 2015. Patients were managed by simultaneous assessment of the YEARS clinical decision rule, consisting of three items

2017 Lancet

67. Update: D-dimer Test for Excluding the Diagnosis of Pulmonary Embolism

Update: D-dimer Test for Excluding the Diagnosis of Pulmonary Embolism TAKE-HOME MESSAGE Patients with a low pretest probability for pulmonary embolism according to a structured clinical prediction rule and a negative D-dimer result are unlikely to have pulmonary embolism, particularly among those younger than 65 years. Update: D-dimer Test for Excluding the Diagnosis of Pulmonary Embolism EBEM Commentators Daniel Kwon, BS Lake Erie College of Osteopathic Medicine Erie, PA Melody Milliron, DO (...) -dimer test. Finally, the review is not able to answer questions about the ability of D-dimer to assess for pulmonary embolism in pregnant patients. Appropriate use of advanced radiographic imaging has been highlighted through national effortssuchastheChoosingWisely campaign, which aims to improve patient care by avoiding wasteful or unnecessary medical tests, treatments,andprocedures. 3 Using a negative D-dimer test result for patients with low pretest probability based on a clinical decision rule

2017 Annals of Emergency Medicine Systematic Review Snapshots

68. The use of veno-venous extracorporeal membrane oxygenation following thrombolysis for massive pulmonary embolism (PubMed)

The use of veno-venous extracorporeal membrane oxygenation following thrombolysis for massive pulmonary embolism A 59-year-old man was diagnosed with a massive pulmonary embolism. Despite thrombolysis there were two episodes of cardiac arrest and following recovery of spontaneous circulation profound cardiorespiratory failure ensued. An extracorporeal membrane oxygenation retrieval team initiated veno-venous extracorporeal membrane oxygenation on site to facilitate transfer (...) to the extracorporeal membrane oxygenation centre. An excellent outcome is reported in the short term. This represents one of the few published cases of veno-venous extracorporeal membrane oxygenation for a massive pulmonary embolism following thrombolysis.

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2017 Journal of the Intensive Care Society

69. Age-adjusted D-Dimer to Exclude Pulmonary Embolism

Age-adjusted D-Dimer to Exclude Pulmonary Embolism Emergency Medicine > Journal Club > Archive > February 2016 Toggle navigation February 2016 Age-adjusted D-Dimer to Exclude Pulmonary Embolism Vignette You are working in a community ED one afternoon when you encounter Mrs. X, a pleasant 65-year old woman with a history of hypertension and osteoporosis, who is in town visiting her grandchildren from California. She flew in 2 days earlier, and for the last 12 hours has noted some right-sided (...) in additional confirmatory testing (CT, VQ scan). Search Strategy PubMed was searched using the terms "age adjusted d-dimer" ( ). This resulted in 148 articles, from which the following 4 were selected. Article 1: Article 2: Article 3: Article 4: Bottom Line In patients who are not high-risk for pulmonary embolism, D-dimer has been shown to be effective at ruling out disease. Unfortunately, this test also has a low specificity and a high false-positive risk. This risk increases (and specificity decreases

2017 Washington University Emergency Medicine Journal Club

70. Imaging for the exclusion of pulmonary embolism in pregnancy. (PubMed)

Imaging for the exclusion of pulmonary embolism in pregnancy. Pulmonary embolism is a leading cause of pregnancy-related death. An accurate diagnosis in pregnant patients is crucial to prevent untreated pulmonary embolism as well as unnecessary anticoagulant treatment and future preventive measures. Applied imaging techniques might perform differently in these younger patients with less comorbidity and altered physiology, who largely have been excluded from diagnostic studies.To determine (...) the diagnostic accuracy of computed tomography pulmonary angiography (CTPA), lung scintigraphy and magnetic resonance angiography (MRA) for the diagnosis of pulmonary embolism during pregnancy.We searched MEDLINE and Embase until July 2015. We used included studies as seeds in citations searches and in 'find similar' functions and searched reference lists. We approached experts in the field to help us identify non-indexed studies.We included consecutive series of pregnant patients suspected of pulmonary

2017 Cochrane

71. Aplastic anemia and risk of deep vein thrombosis and pulmonary embolism: A nationwide cohort study

Aplastic anemia and risk of deep vein thrombosis and pulmonary embolism: A nationwide cohort study Deep vein thrombosis (DVT) and pulmonary embolism (PE) constitute venous thromboembolism (VTE), which is not fully known in aplastic anemia (AA). Therefore, we investigated the incidence and risk of VTE in AA patients.We conducted a nationwide cohort study to investigate the risk of DVT and PE in patients with AA. We identified patients with newly diagnosed AA as the AA cohort between 2000

2017 EvidenceUpdates

73. Thrombolytic therapy for pulmonary embolism and extensive iliofemoral deep vein thrombosis

Thrombolytic therapy for pulmonary embolism and extensive iliofemoral deep vein thrombosis

2017 DynaMed Plus

77. Pulmonary Embolism Diagnosis and Treatment

Pulmonary Embolism Diagnosis and Treatment ? 2017 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Pulmonary Embolism Diagnosis & Treatment Guideline Background 2 Evaluation and Diagnosis Adults 3 Pregnant women 4 Adults with cancer 5 Choice of Treatment Setting 6 Subsegmental PE: Treatment Versus Surveillance 8 Treatment with Anticoagulation Medications 9 Recommended testing 9 Choice of anticoagulant medications by population 9 Dosing of anticoagulant medications 11 Duration (...) guideline was developed by Kaiser Permanente Washington (KPWA). 2 Background Pulmonary embolism (PE) is a relatively common vascular disease with potentially life-threatening complications in the short term. The accurate incidence of the condition is unknown, but it is estimated that 200,000 to 500,000 patients are diagnosed with PE each year in the United States. Many of these cases are diagnosed in the emergency department (White 2016). Traditionally, patients with PE are treated in the hospital

2017 Kaiser Permanente Clinical Guidelines

78. Deep Vein Thrombosis in Patients with Pulmonary Embolism: Prevalance, Clinical Significance and Outcome (PubMed)

Deep Vein Thrombosis in Patients with Pulmonary Embolism: Prevalance, Clinical Significance and Outcome Deep venous thrombosis (DVT) and pulmonary embolism (PE) are considered as similar disease entities representing different clinical manifestations. The objectives of this study were: 1) to determine the prevalence and outcome of DVT in patients with PE; 2) to identify additional risk factors for PE-related unfavorable outcome and 30-day all-cause mortality; and 3) to establish the clinical

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2016 Vascular specialist international

79. Subacute right heart failure revealing three simultaneous causes of post‐embolic pulmonary hypertension in metastatic dissemination of breast cancer (PubMed)

Subacute right heart failure revealing three simultaneous causes of post‐embolic pulmonary hypertension in metastatic dissemination of breast cancer A 72-year-old woman with history of breast cancer only treated surgically was referred to our department for pulmonary hypertension (PH) suspicion. Echocardiogram revealed elevated right ventricular systolic pressure. Computed tomography (CT) angiogram showed no pulmonary embolism (PE), but lung scan revealed two ventilation-perfusion mismatch (...) areas. Right cardiac catheterization established precapillary PH. Despite treatment with PH specific therapy (sildenafil, ambrisentan, and epoprostenol), her condition worsened rapidly with acute right heart failure (RHF). She died 22 days after admission. Post-mortem microscopic examination showed a rare combination of PH etiologies consistent with metastasis of breast cancer in pulmonary vasculature including the rare pulmonary tumour thrombotic microangiopathy (PTTM).

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2016 ESC heart failure

80. Risk stratifying emergency department patients with acute pulmonary embolism: Does the simplified Pulmonary Embolism Severity Index perform as well as the original?

Risk stratifying emergency department patients with acute pulmonary embolism: Does the simplified Pulmonary Embolism Severity Index perform as well as the original? The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score to estimate the 30-day mortality of emergency department (ED) patients with acute pulmonary embolism (PE). A simplified version (sPESI) was derived but has not been as well studied in the U.S. We sought to validate both indices in a community hospital

2016 EvidenceUpdates