[Clinical analysis of acute pulmonary thromboembolism in 68 elderly patients].

Xiao Fang Wang, Wei Xuan Lu, Guo Li, Ju Hong Shi, Chen Wang

Research output: Contribution to journalArticle

Abstract

To explore the clinical characteristics of acute pulmonary thromboembolism (PTE) in elderly patients, in order to improve the diagnosis and treatment of the disease. The clinical data were reviewed for patients aged over 60 years old hospitalized with acute PTE in Peking Union Medical College Hospital from January 2006 to January 2009. The average age of the 68 patients was (72 +/- 6) years old. Deep vein thromboembolism was found in 33 cases. Hypertension (55.9%), cancer (32.4%), surgery (29.4%), immobility (29.4%), diabetes (23.5%) and obesity (20.6%) were the most common risk factors, with 70.6% (48/68) of these patients having more than 2 risk factors. The common symptoms were dyspnea (77.9%), cough (26.5%), chest pain (13.2%), palpitation (13.2%), faint (13.2%) and asymmetric edema of the lower extremities (30.9%). All of the arterial blood gas in 61 cases showed hypoxemia. The positive rate of blood D-dimer elevation was 84% (47/56). The main signs in chest X-ray were infiltrates (37.5%) and pleural effusions (18.8%). Non-specific ST-T changes (59.3%) and sinus tachycardia (23.7%) were the most common abnormalities in electrocardiogram. Forty seven cases (69.1%) were diagnosed through CT pulmonary angiography (CTPA), and 20 cases (29.4%) were through ventilation-perfusion lung scintigraphy. Sixty one cases received anticoagulant therapy and 5 received thrombolytic therapy. Vena cava filters were implanted in 5 patients. Fifty six cases improved after treatment, and the case fatality ratio was 18% (12/68). The most common risk factors for PTE in elderly patients were chronic diseases, cancer, surgery and immobility. The symptoms and auxiliary examination of these patients were not specific, and CTPA was the most useful diagnosing tool. Anticoagulation was the basic treatment for PTE in elderly patients and it was safe and effective, while the overuse of thrombolytic therapy and vena cava filter should be avoided.

Original languageEnglish (US)
Pages (from-to)206-209
Number of pages4
JournalZhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
Volume33
Issue number3
StatePublished - Mar 2010

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Pulmonary Embolism
Vena Cava Filters
Thrombolytic Therapy
Lung
Sinus Tachycardia
Perfusion Imaging
Thromboembolism
Pleural Effusion
Therapeutics
Chest Pain
Cough
Dyspnea
Anticoagulants
Ventilation
Lower Extremity
Veins
Edema
Neoplasms
Electrocardiography
Chronic Disease

ASJC Scopus subject areas

  • Medicine(all)

Cite this

[Clinical analysis of acute pulmonary thromboembolism in 68 elderly patients]. / Wang, Xiao Fang; Lu, Wei Xuan; Li, Guo; Shi, Ju Hong; Wang, Chen.

In: Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases, Vol. 33, No. 3, 03.2010, p. 206-209.

Research output: Contribution to journalArticle

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