Characteristics of PE in Elderly and Young Patients

BackgroundFeatures of pulmonary embolism may be different in elderly than the in young patients. The purpose of the study is to examine the characteristics of PE in elderly and young patients.Patients and MethodsWe conducted a retrospective study by examining the digital medical records of consecutive patients (>18 years old)who underwent CTPA at our center for suspected pulmonary embolism between 2013 and 2019. We classified the patients as elderly (≥65 years) and younger group (<65).ResultsEnlarged complete artery occlusion (67.5% vs 32.1%, P = .0001), polo mint sign (47.2% vs 25.2%, P = .0001) and partial filling defect with acute angle(57.7% vs 30.5%, P = .0001) were more frequent in younger patients compared to elderly group. Shrunken complete artery occlusion (62.6% vs 32.5%, P = .0001),thickened small arteries (64.1% vs 33.3%, P = .0001),bilateral pleural effusions(16.8% vs 4.9%, P = .002),variation in the size of segmental vessels (30.5 vs 8.9, P = .0001) and mosaic perfusion pattern (55.0% vs 28.5%, P = .0001) occurred more often in the elderly group compared to younger patients. Presence of right ventricular dysfunction (RV/LV diameter ratio ≥ 1), lower oxygen saturation determined while breathing room air on admission and increased pulmonary artery diameter seem to be associated with an increased risk of in-hospital mortality in pulmonary embolism patients in logistic procedures. In another logistical procedure, age and pulmonary artery diameter are important determinants of in-hospital death in patients with pulmonary embolism.ConclusionsThe CT findings of pulmonary embolism in elderly and young patients are significantly different, with chronic features in the elderly and acute features in the younger. Age and characteristics of acute and chronic pulmonary embolism, such as a high RV/LV ratio, low oxygen saturation on admission, and an increased pulmonary artery diameter, may determine outcomes.