[Pulmonary thromboembolism in the elderly]

To describe the characteristics of pulmonary thromboembolism (PTE) in the elderly and to identify potential differences between elderly and non-elderly patients.

Retrospective review of 154 consecutive patients diagnosed of PTE in an Internal Medicine service between January 1993 and December 2001.

Ninety patients (58.4%) were older than 70 years. Prior cardiopulmonary disease was significantly more frequent in patients older than 70 years (41.1% vs 23.4%, p = 0.03). Deep venous thrombosis (DVT) clinic was significantly less frequent in older than 70 years (36.7% vs 53.1%, p = 0.04). The rest of studied characteristics was similar in both groups. Four patients older than 70 years (4.4%) did not have "classical" symptoms of PTE (dyspnea, centrothoracic pain, pleuritic pain and/or hemoptysis). Three patients older than 70 years (3.3%) did not have "classical" signs of PTE (tachypnea, tachycardia and/or crackles) nor DVT clinic. Three patients older than 70 years (3.3%) had a normal alveolar-arterial oxygen gradient. Hospital death was more frequent in older than 70 years, but without reaching statistical significance (8.9% vs 3.1%, p > 0.05).

PTE characteristics are similar in elderly and in non-elderly patients, although DVT clinic is less frequent in elderly. The absence of "classical" symptoms of PTE, the absence of "classical" signs of PTE and DVT clinic, and a normal alveolar-arterial oxygen gradient are very infrequent in elderly with PTE. Hospital mortality in PTE may be higher in patients older than 70 years.