Clinical presentation and mortality in pulmonary embolism: the Optimev study

To describe the clinical presentation and 3-month mortality in recognized forms of venous thromboembolism (VTE).

All 8256 patients referred to 359 vascular physicians for clinical suspicion of VTE were included over a 15-month period in France. Subjects without a confirmed diagnosis of VTE served as controls. Risk factors, clinical presentation and estimated 3-month survival for each form of VTE were evaluated.

Of 5889 patients, 426 had pulmonary embolism (PE) with deep vein thrombosis (DVT), 148 had PE without DVT, and 5315 had no VTE. 2350 patients with other VTE events (DVT and superficial vein thrombosis) and 17 other patients were excluded of the analysis. PE without DVT patients presented differently for risk factors in the univariate analysis. Three-month mortality was 4.0% for controls, 12.9% for PE with DVT, and 4.6% for PE without DVT. Compared with controls, only PE with DVT patients (adjusted hazard ratio: 2.6 95% CI [1.4-4.7]) were at increased risk of mortality.

PE without DVT is not associated with a higher 3-month mortality compared to controls, in contrast to PE with DVT. When diagnosing PE in patients, the clinical significance of an associated DVT is important.