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Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-1723
Lissolo S., Cavallo E., Ronchetto F.
Department of Geriatrics Cuorgnè Hospital, Cuorgnè, Turin, Italy
Aim. A retrospective hospital study has been carried out to evaluate the incidence of pulmonary embolism (PE) and its clinical characteristics among old patients.
Methods. The cases of PE diagnosed among old patients admitted to a getriatric hospital unit (Cuorgnè Hospital, Italy) during a 24-month period were reviewed.
Results. The incidence of PE was 1.4% (20 cases). Nineteen cases were nonhospital acquired. Six (30%) patients had a concomitant deep vein thrombosis. The most common diseases associated with venous thromboembolism were arterial hypertension, heart failure and chronic lung disease; 4 patients had a concomitant acute pneumonia; 3 patients a recent hip fracture. Spiral chest computed tomography of 18 patients showed one or more emboli in the right pulmonary arteries of 10 patients (55.5%), whereas in 7 (38.8%) patients emboli were bilateral, and 1 patient had an embolus in a left segmental artery. All the patients were treated with heparin, mostly with a low molecular weight heparin (nadroparin). In 14 patients heparin was used as a bridge to warfarin. Thrombolytic therapy with alteplase was used in 1 case of massive PE and cardiogenic shock. No death occurred.
Conclusion. The study seems to indicate that the incidence of PE among old patients is not negligible, but, when properly diagnosed and treated, it is associated with a low hospital mortality.