PULMONARY EMBOLISM RISK FACTORS, PRESENTATION AND MANAGEMENT: A CROSS SECTIONAL STUDY

Abstract

Objective: To analyse the presenting symptoms, risk factors, management andoutcome of patients admitted with pulmonary embolism.

Methodology: Patients admitted to Cardiology department, Lady ReadingHospital, Peshawar as pulmonary embolism in the last 18 months, from 1stJanuary 2018 to 10th June 2019, were enrolled utilizing convenient sampling.Patients were analyzed for presenting symptoms, risk factors, hemodynamicparameters,Well's score, ECG, Echo, CTPA parameters, treatments received andmortality. Frequency, mean and standard deviation were determined. Sensitivityand specificity was calculated for ECG signs, RV dilatation and pulmonaryhypertension against CTPA.

Results: Out of 5917 admissions 31 (0.5%) patients were diagnosed aspulmonary embolism. Mean age 46 + 16 years, male 45.2 %. The presentingsymptoms were dyspnea 96.8%, chest pain 61.3% and dizziness 32.3%. Riskfactors were immobilization 80.6%, hypertension 41.9% and diabetes 25.8%. Ddimmerswere high in 96.3%. Right ventricular dilatation was documented in77.4% having sensitivity 87.5% and specificity 20%. Pulmonary hypertensionwas determined in 74.2% with sensitivity 81% and specificity 40%. CTPA wasperformed in 19 out of 31(61.3%) patients and of them14/19 (73.6%) hadevidence of pulmonary embolism. Anticoagulants were given in 90.3% whilethrombolytic in 9.7%. Mortality was 5/5917 (0.1%) of the total admissions and5/31 (16.1%) of the patients admitted as pulmonary embolism. The hospitalmortality was zero in those having no pulmonary clot on CTPA.

Conclusion: Dyspnea is the most common presenting symptom in pulmonaryembolism. Immobilization is the most common risk factor for pulmonaryembolism. The in hospital mortality of Pulmonary embolism is 16% in our studypopulation.