Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism.
Blood. 2013 Jun 4;
Authors: den Exter PL, van Es J, Klok FA, Kroft LJ, Kruip MJ, Kamphuisen PW, Büller HR, Huisman MV
The clinical significance of subsegmental pulmonary embolism (SSPE) remains to be determined. This study aimed to investigate whether SSPE forms a distinct subset of thromboembolic disease compared to more proximally located pulmonary embolism (PE). We analyzed 3728 consecutive patients with clinically suspected PE. SSPE patients were contrasted to patients with more proximal PE and to patients in who suspected PE was ruled out, as regards the prevalence of thromboembolic risk factors and the 3-month risks of recurrent venous thromboembolism (VTE) and mortality. PE was confirmed in 748 patients, of whom 116 (16%) had SSPE; in 2980 patients PE was ruled out. No differences were seen in the prevalence of VTE risk factors, the 3-month risk of recurrent VTE (3.6% vs 2.5%; p=0.42) and mortality (10.7% vs 6.5%; p=0.17) between patients with SSPE and those with more proximal PE. When compared to patients without PE, age >60 years, recent surgery, estrogen use, and male gender were found to be independent predictors for SSPE, and patients with SSPE were at increased risk of VTE during follow-up (HR: 3.8; 95% CI: 1.3-11.1). This study indicates that patients with SSPE mimic those with more proximally located PE as regards their risk profile and clinical outcome.
PMID: 23736701 [PubMed - as supplied by publisher]