Delay in thrombolysis of massive and submassive pulmonary embolism

To report the time of delay in thrombolysis of massive and submassive pulmonary embolism (PE).

We enrolled 83 consecutive patients with massive and submassive PE from 8 hospitals between June 2006 and March 2009. We recorded the delay between symptom onset and thrombolysis. The clinical findings related to early thrombolysis (delay ≤ 2 days) were analyzed.

Median of the delay in thrombolysis was 8 days with 82% over 2 days, 53% over 7 days, and 6% over 25 days. Compared to the late thrombolysis (delay >2 days), patients with early thrombolysis more frequently had murmurs at the tricuspid area (26.7% vs 6.1%, P = .053), less frequently had cough (20% vs 59.7%, P = .005) and increased P2 (pulmonic component of second heart sound; 33.3% vs 61.2%, P = .049), and more patients were thrombolysed in off-hours (86.7% vs 57.4%, P = .034).

The time of delay in thrombolysis is too long and the symptoms and signs between early and late thrombolysis groups may differ.