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Clinical Characteristics of Pulmonary Embolism: A Single Institutional Experience
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A3769 - Clinical Characteristics of Pulmonary Embolism: A Single Institutional Experience
Author Block: A. Iftikhar1, J. Centeno2, A. Hines3, M. Cheema2, A. Adial4, H. Singh1, A. J. Smith5; 1Pulmonary and Critical care, New york Presbyterian Queens, Flushing, NY, United States, 2NYPQ, Flushing, NY, United States, 3New York Presbyterian Queens, Flushing, NY, United States, 4Pulmonary, NYPQ, Flushing, NY, United States, 5New York Presbyterian Queens, New York, NY, United States.
Introduction: The challenge in dealing with pulmonary embolism is that patients rarely display the classic presentation of this problem, that is, the abrupt onset of pleuritic chest pain, shortness of breath, and hypoxia. Selection of patients for diagnostic tests for acute pulmonary embolism requires recognition of the possibility of pulmonary embolism based on the clinical characteristics.
Material and Methods: We conducted a retrospective chart review at New York Presbyterian Hospital Queens, enrolling all patients who had the diagnosis of pulmonary embolism with ICD10 code I26.0 admitted to hospital from Jan 2015- July 2017. All charts and CT Scans were reviewed, and patients who had a positive CTA were enrolled. Demographics, initial presentation, di-dimer, troponin, BNP, CBC and Venous Doppler results were analyzed.
Results: A total of 760 patients were identified with diagnosis of pulmonary embolism, 498 patients were excluded because of insufficient data. There were 262 patients who met the study criteria (what were the inclusion criteria?) There were 141 (53.8%) females and 121(46.1%) males with a mean age of 70.73 ± 18.4 and 65.08± 15.28 respectively. The clinical presentations included dyspnea (66.41%), chest pain (15.65%), leg swelling (9.5%), syncope (8.4%) and hypoxemia (8.01%). Patient populations were mostly white 129 (49.2%) , African American 53 (20.22%), Asian 49(18.70%), Hispanic 25( 9.54%) and Unknown 11( 4.19%). 35 of 262 (13.35%) of patients had elevated pulmonary artery pressures(PAP) at echocardiography with elevated BNP and troponin with Mean of 49.4±12.75, 0.11± 0.10, 9633.55±12940 respectively. From these 35 patients 16(45.71 %) male and 19(54.28%) was female. Symptoms on presentation in this group included dyspnea (71.4 %), syncope (14.2%), hypoxia (14.2%), Chest pain (11.4%), and leg swelling (8.5%).Ethnicity in this group was white 20 (57.1%), African American 6 (17.1%), Asian 4 (11.4%), Hispanic 3(8.5%), and Unknown 2(5.7%). From 35 patient 17 (48.5%) have positive Deep Venous thrombosis (DVT) and 18 (51.42%) does not have positive DVT.
Conclusion: Pulmonary embolism is common problem and often under recognized and under diagnosed. A high index suspicion is necessary to consider diagnosis. Early diagnosis and aggressive treatment and improve outcome in a potentially fatal condition. Our center population have almost same presentation with other patients in medical studies published worldwide, dyspnea being the most common presenting symptom.
Author Block: A. Iftikhar1, J. Centeno2, A. Hines3, M. Cheema2, A. Adial4, H. Singh1, A. J. Smith5; 1Pulmonary and Critical care, New york Presbyterian Queens, Flushing, NY, United States, 2NYPQ, Flushing, NY, United States, 3New York Presbyterian Queens, Flushing, NY, United States, 4Pulmonary, NYPQ, Flushing, NY, United States, 5New York Presbyterian Queens, New York, NY, United States.
Introduction: The challenge in dealing with pulmonary embolism is that patients rarely display the classic presentation of this problem, that is, the abrupt onset of pleuritic chest pain, shortness of breath, and hypoxia. Selection of patients for diagnostic tests for acute pulmonary embolism requires recognition of the possibility of pulmonary embolism based on the clinical characteristics.
Material and Methods: We conducted a retrospective chart review at New York Presbyterian Hospital Queens, enrolling all patients who had the diagnosis of pulmonary embolism with ICD10 code I26.0 admitted to hospital from Jan 2015- July 2017. All charts and CT Scans were reviewed, and patients who had a positive CTA were enrolled. Demographics, initial presentation, di-dimer, troponin, BNP, CBC and Venous Doppler results were analyzed.
Results: A total of 760 patients were identified with diagnosis of pulmonary embolism, 498 patients were excluded because of insufficient data. There were 262 patients who met the study criteria (what were the inclusion criteria?) There were 141 (53.8%) females and 121(46.1%) males with a mean age of 70.73 ± 18.4 and 65.08± 15.28 respectively. The clinical presentations included dyspnea (66.41%), chest pain (15.65%), leg swelling (9.5%), syncope (8.4%) and hypoxemia (8.01%). Patient populations were mostly white 129 (49.2%) , African American 53 (20.22%), Asian 49(18.70%), Hispanic 25( 9.54%) and Unknown 11( 4.19%). 35 of 262 (13.35%) of patients had elevated pulmonary artery pressures(PAP) at echocardiography with elevated BNP and troponin with Mean of 49.4±12.75, 0.11± 0.10, 9633.55±12940 respectively. From these 35 patients 16(45.71 %) male and 19(54.28%) was female. Symptoms on presentation in this group included dyspnea (71.4 %), syncope (14.2%), hypoxia (14.2%), Chest pain (11.4%), and leg swelling (8.5%).Ethnicity in this group was white 20 (57.1%), African American 6 (17.1%), Asian 4 (11.4%), Hispanic 3(8.5%), and Unknown 2(5.7%). From 35 patient 17 (48.5%) have positive Deep Venous thrombosis (DVT) and 18 (51.42%) does not have positive DVT.
Conclusion: Pulmonary embolism is common problem and often under recognized and under diagnosed. A high index suspicion is necessary to consider diagnosis. Early diagnosis and aggressive treatment and improve outcome in a potentially fatal condition. Our center population have almost same presentation with other patients in medical studies published worldwide, dyspnea being the most common presenting symptom.
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