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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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[Risk factors for hospital mortality during pulmonary embolism].

J El Ghoul1, A Bendayekh2, W Fki3

  • 1Service de pneumologie, hôpital Habib-Bourguiba, 4100 Médenine, Tunisie.

Annales De Cardiologie Et D'Angeiologie
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PubMed
Summary

Hospital mortality in pulmonary embolism (PE) patients remains high. Key risk factors include arterial hypotension, cancer, elevated VD/LV ratio, and severe hypoxemia, necessitating improved patient management strategies.

Keywords:
Embolie pulmonaireMortalityMortalitéPrognosisPronostic ;TunisiePulmonary embolismTunisia

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Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Epidemiology

Background:

  • Pulmonary embolism (PE) poses a significant mortality risk despite advances in care.
  • Identifying specific risk factors for in-hospital death is crucial for targeted interventions.

Purpose of the Study:

  • To identify independent risk factors associated with hospital mortality in patients diagnosed with PE.
  • To inform strategies for better patient management and improved survival rates in a pneumology department.

Main Methods:

  • Retrospective analysis of 100 patients admitted with PE between 2014 and 2019.
  • Inclusion criteria: final diagnosis of PE.
  • Statistical analysis to determine independent risk factors for in-hospital mortality.

Main Results:

  • The overall hospital mortality rate was 12%.
  • Independent risk factors for mortality included arterial hypotension (OR: 6.13), cancer (OR: 2.66), VD/LV ratio > 0.9 (OR: 1.84), and severe hypoxemia (OR: 4.86).
  • Pulmonary fibrosis was present in 8% of patients; mean age was 63±16 years.

Conclusions:

  • Hospital mortality from PE remains a concern, underscoring the need for enhanced management protocols.
  • Arterial hypotension, cancer, specific echocardiographic findings (VD/LV ratio), and severe hypoxemia are critical predictors of mortality.
  • These findings emphasize the importance of considering identified risk factors for improved patient outcomes in national healthcare strategies.