Document Detail


Silent pulmonary embolism in patients with deep venous thrombosis: a systematic review.
MedLine Citation:
PMID:  20399319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine, by systematic review of the literature, the prevalence of silent pulmonary embolism in patients with deep venous thrombosis.
METHODS: Twenty-eight included published investigations were identified through PubMed. Studies were selected if methods of diagnosis of pulmonary embolism were described; if pulmonary embolism was stated to be asymptomatic; and if raw data were presented. Studies were stratified according to whether silent pulmonary embolism was diagnosed by a high-probability ventilation-perfusion lung scan using criteria from the Prospective Investigation of Pulmonary Embolism Diagnosis, computed tomography pulmonary angiography, or conventional pulmonary angiography (Tier 1), or by lung scans based on non-Prospective Investigation of Pulmonary Embolism Diagnosis criteria (Tier 2).
RESULTS: Silent pulmonary embolism was diagnosed in 1665 of 5233 patients (32%) with deep venous thrombosis. This is a conservative estimate because many of the investigations used stringent criteria for the diagnosis of pulmonary embolism. The incidence of silent pulmonary embolism was higher with proximal deep venous thrombosis than with distal deep venous thrombosis. Silent pulmonary embolism seemed to increase the risk of recurrent pulmonary embolism: 25 of 488 (5.1%) with silent pulmonary embolism versus 7 of 1093 (0.6%) without silent pulmonary embolism.
CONCLUSION: Silent pulmonary embolism sometimes involved central pulmonary arteries. Because approximately one third of patients with deep venous thrombosis have silent pulmonary embolism, routine screening for pulmonary embolism may be advantageous.
Authors:
Paul D Stein; Fadi Matta; Muzammil H Musani; Benjamin Diaczok
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  123     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-04-29     Revised Date:  2011-01-12    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  426-31     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Departments of Internal Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA. steinp@trinity-health.org
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MeSH Terms
Descriptor/Qualifier:
Humans
Pulmonary Embolism / complications,  diagnosis*
Venous Thrombosis / complications*
Comments/Corrections
Comment In:
Am J Med. 2010 Dec;123(12):e15. author reply e17   [PMID:  20961520 ]
Am J Med. 2011 Jan;124(1):e15; author reply e17   [PMID:  20934671 ]

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