| Computerized tomographic finding of saddle pulmonary embolism is associated with high mortality in cancer patients. | |
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MedLine Citation:
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PMID: 19220554 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Large pulmonary embolism (PE) is associated with high mortality in cancer patients. Several risk stratification methods have been used in PE setting. While computer-assisted tomography (CT) is now the preferred diagnostic modality for PE, its prognostic value is not well established. METHODS: A retrospective study of patients discharged from our centre between 2000 and 2006 with a PE diagnosis identified 52 patients with thrombus in the main pulmonary artery or the right or left branch. Clinical, echocardiographic and CT data were reviewed; vital status was determined 1 month and 1 year after index event. Patients were divided into saddle (defined as main pulmonary artery thrombus) and non-saddle PE. Multivariate logistic regression was applied to predict vital status, with patient age and CT parameters as predictors. RESULTS: Eighteen out of 52 patients were found to have a saddle PE. No significant difference was found between the group characteristics, although saddle PE patients were more likely to receive thrombolytic therapy (27.8% vs 2.9%, P = 0.02) and have an echocardiogram within 30 days of PE (61.1% vs 29.4%, P = 0.03). Overall mortality at 1 month was 9.6% with no difference between groups. At 1 year, mortality rates in saddle PE were significantly higher (83.3% vs 41.2%, P = 0.004). Presence of saddle PE was associated with an odds ratio of death within 1 year of 7.41 (95% confidence interval: 1.75-31.46, P = 0.007). CONCLUSION: The relatively simple distinction of saddle versus non-saddle PE by CT findings may provide a straightforward method for risk stratification, and remains useful up to 1 year after the index event. |
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Authors:
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S W Yusuf; G Gladish; D J Lenihan; X Lei; J-B Durand; J Swafford; I N Daher |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-02-10 |
Journal Detail:
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Title: Internal medicine journal Volume: 40 ISSN: 1445-5994 ISO Abbreviation: Intern Med J Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-06-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101092952 Medline TA: Intern Med J Country: Australia |
Other Details:
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Languages: eng Pagination: 293-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. syusuf@mdanderson.org |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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