| Christchurch experience of pulmonary embolism with and without thrombolysis. | |
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MedLine Citation:
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PMID: 20953221 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Thrombolysis for normotensive patients with large clot burden pulmonary embolism remains debatable. We aim to document our current management of pulmonary embolism, examining determinants of therapy and outcomes. METHOD: A retrospective chart-based review of all patients admitted with pulmonary embolism under Cardiology service in Christchurch Hospital between 2002-2007. All related CT pulmonary angiograms were also reviewed for quantification of clot burden and evidence of right ventricular strain. RESULTS: 120 patients were admitted during the audit period. Hypotensive patients had a significantly higher troponin level and Qanadli scores. RV/LV ratio >1 in CTPA was 80% sensitive and 57% specific in predicting RV strain on echocardiogram. Forty-six patients were thrombolysed, most with large clot burden and right ventricular strain. No treatment related death or intracranial haemorrhages occurred; however six patients required blood transfusion and six patients had persistent pulmonary hypertension at 6 months. There was a higher in-patient event rate in thrombolysed group, due to increased bleeding, compared to non-thrombolysed patients. CONCLUSION: Thrombolysis was successfully performed with relatively low in-patient and 6-month event rate. Long term advantage over routine anticoagulation was not demonstrated. The role of thrombolysis in normotensive patients with large clot burden remains uncertain. CTPA markers of RV strain correlated well with echocardiography. |
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Authors:
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Wandy Chan; Tiffany Campbell; Sharyn MacDonald; Ian Crozier |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-10-15 |
Journal Detail:
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Title: The New Zealand medical journal Volume: 123 ISSN: 1175-8716 ISO Abbreviation: N. Z. Med. J. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-18 Completed Date: 2010-11-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401067 Medline TA: N Z Med J Country: New Zealand |
Other Details:
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Languages: eng Pagination: 41-9 Citation Subset: IM |
Affiliation:
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Cardiology Department, Christchurch Public Hospital, Christchurch, New Zealand. wandyc@cdhb.govt.nz |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography Cardiology Service, Hospital* Female Fibrinolytic Agents / therapeutic use* Follow-Up Studies Humans Incidence Male Middle Aged New Zealand / epidemiology Prognosis Pulmonary Embolism / drug therapy*, epidemiology, radiography Retrospective Studies Survival Rate / trends Thrombolytic Therapy / methods*, utilization Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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