Diagnosis and treatment of acute pulmonary embolism: A single center experience

Yıl 2022, Cilt: 6 Sayı: 1, 87 - 92, 27.03.2022

Ayşe Ertekin , Aydın Balcı , Erhan Bozkurt , Emre Atay , Ramazan Sami Aktaş

https://doi.org/10.30565/medalanya.1017887

Öz

Aim: Pulmonary embolism is a potentially life-threatening cardiovascular disease frequently encountered in emergency departments. The computed tomography pulmonary angiography is the imaging modality of choice in the diagnosis of pulmonary embolism. This study aimed to examine the effects of clinical findings and treatment methods on prognosis and mortality by examining patients diagnosed with acute pulmonary embolism in the emergency department.

Methods: In this retrospective cohort study, records of patients with acute pulmonary embolism were accessed from the archive. Patients' age, gender, medical complaints, co-morbidities, the treatment method applied to the patients, and the clinical outcomes of the patients were analyzed. The statistical distribution of the patients' demographic and clinical information was calculated.

Results: The most common complaint of 206 patients with acute pulmonary embolism was dyspnea. 25.7% patients had massive pulmonary embolism. The blood d-dimer, lactate and troponin T levels of patients with massive pulmonary embolism were found to be higher than patients with sub-massive pulmonary embolism. Thrombolytic therapy was administered to 6.8% of acute pulmonary embolism patients and it was found to be a method that had a statistically positive effect on survival. D-dimer, white blood cell, neutrophil, blood urea nitrogen, lactate and troponin T values were found to be higher in mortal patients. It was determined that 13.1% of the patients died.

Conclusion: The sooner the early diagnosis of acute pulmonary embolism, which can be mortal in the emergency department, is made and the treatment is started, the mortality rate will decrease significantly.

Anahtar Kelimeler

pulmonary embolism, thrombolytic therapy, emergency department

Akut pulmoner emboli tanı ve tedavisi: Tek merkez deneyimi

Öz

Amaç: Pulmoner emboli, acil servislerde sıklıkla karşılaşılan, potansiyel olarak yaşamı tehdit eden bir kardiyovasküler hastalıktır. Bilgisayarlı tomografi pulmoner anjiyografi, pulmoner emboli tanısında tercih edilen görüntüleme yöntemidir. Bu çalışmada, acil serviste akut pulmoner emboli tanısı konulan hastaları inceleyerek klinik bulguların ve tedavi yöntemlerinin prognoz ve mortalite üzerine etkilerini incelemeyi amaçladık.

Yöntem: Bu retrospektif kohort çalışmada akut pulmoner emboli hastalarının kayıtlarına arşivden ulaşıldı. Hastaların yaşı, cinsiyeti, tıbbi şikayetleri, ek hastalıkları, hastalara uygulanan tedavi yöntemi ve hastaların klinik sonuçları analiz edildi. Hastaların demografik ve klinik bilgilerinin istatistiksel dağılımı hesaplandı.

Bulgular: Akut pulmoner embolili 206 hastanın en sık şikayeti nefes darlığıydı. Hastaların %25.7'sinde masif pulmoner emboli vardı. Masif pulmoner emboli hastalarında kan d-dimer, laktat ve troponin T düzeyleri submasif pulmoner emboli hastalarına göre daha yüksek bulundu. Akut pulmoner emboli hastalarının %6.8'ine trombolitik tedavi uygulanmış ve sağ kalımı istatistiksel olarak olumlu etkileyen bir yöntem olduğu saptanmıştır. Mortal hastalarda d-dimer, beyaz küre, nötrofil, kan üre nitrojen, laktat ve troponin T değerleri daha yüksek bulundu. Hastaların %13.1'inin hayatını kaybettiği belirlendi.

Sonuç: Acil serviste ölümcül olabilen akut pulmoner emboli ne kadar erken teşhis edilir ve tedavisine başlanırsa mortalite oranı önemli ölçüde azalacaktır.

Anahtar Kelimeler

: pulmoner emboli, trombolitik tedavi, acil servis

Kaynakça

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