Predictors of Residual Pulmonary Vascular Obstruction after Pulmonary Embolism: results from a prospective cohort study

Author(s):  
Francis Couturaud ◽  
Gael Picart ◽  
Philippe Robin ◽  
Cécile Tromeur ◽  
Raphael Le Mao ◽  
...  
2020 ◽  
Vol 26 ◽  
pp. 107602962094107
Author(s):  
Abera Mulatu ◽  
Tsegaye Melaku ◽  
Legese Chelkeba

Deep venous thrombosis (DVT) is a common clinical problem associated with substantial morbidity and mortality. Knowledge of the global burden of DVT recurrence is deficient in Africa, including Ethiopia. The objective of the study was to assess deep venous thrombosis recurrence and its predictors at selected tertiary hospitals in Ethiopia. Prospective cohort study was conducted among hospitalized DVT patients. Data were analyzed using SPSS version 21.0. To identify the independent predictors of DVT-recurrence, multiple stepwise-backward Cox-regression analysis was done. Statistical significance was considered at P value < .05. A total of 129 participants were included (65.1% females) with mean ± SD age of 38.63 ± 17.67 years. About 26.4% of patients developed recurrent venous thromboembolism. Pulmonary embolism accounted for 17.60% of recurrent event. The overall incidence density of DVT recurrence was 2.99 per 1000 person-days. The mean ± SD survival time to DVT recurrence was 42.03 ± 22.371 days. Age ≥ 50 years (adjusted hazard ratio [AHR]: 5.566; 95% CI: 1.587-19.518; P = .007), occasional alcohol consumption (AHR: 2.011; 95% CI: 1.307-6.314; P = .019), surgical history (AHR: 6.218; 95% CI: 1.540-25.104; P = .010), pregnancy (AHR: 2.0911; 95% CI: 1.046-4.179; P = .037), diabetes mellitus (AHR: 8.048; 95% CI: 2.494-25.966; P < .001), unmet activated partial thromboplastin time target after 24 hours of heparin (AHR: 1.129; 95% CI: 0.120-10.600; P = .011), proximal site involvement (AHR: 5.937; 95% CI: 1.300-27.110; P = .022), and previous history of DVT (AHR: 2.48; 95% CI: 1.085-11.20; P = .0002) were independent predictors of DVT recurrence. The DVT recurrence rate was high in the study area, which is even complicated with pulmonary embolism as well as death. Efforts are needed to prevent and reduce the development of DVT recurrence.


2016 ◽  
Vol 148 ◽  
pp. 70-75 ◽  
Author(s):  
Benjamin Planquette ◽  
Alexis Ferré ◽  
Julien Peron ◽  
Amandine Vial-Dupuy ◽  
Jean Pastre ◽  
...  

Author(s):  
Charles Orione ◽  
Cécile Tromeur ◽  
Raphael Le Mao ◽  
Pierre-Yves Le Floch ◽  
Philippe Robin ◽  
...  

Abstract Background We aimed to assess whether high pulmonary vascular obstruction index (PVOI) measured at the time of pulmonary embolism (PE) diagnosis is associated with an increased risk of recurrent venous thromboembolism (VTE). Study Design and Methods French prospective cohort of patients with a symptomatic episode of PE diagnosed with spiral computerized tomography pulmonary angiography (CTPA) or ventilation-perfusion (V/Q) lung scan and a follow-up of at least 6 months after anticoagulation discontinuation. PVOI was assessed based on the available diagnostic exam (V/Q lung scan or CTPA). All patients had standardized follow-up and independent clinicians adjudicated all deaths and recurrent VTE events. Main outcome was recurrent VTE after stopping anticoagulation. Results A total of 418 patients with PE were included. During a median follow-up period of 3.6 (1.2–6.0) years, 109 recurrences occurred. In multivariate analysis, PVOI ≥ 40% was an independent risk factor for recurrence (hazard ratio 1.77, 95% confidence interval 1.20–2.62, p < 0.01), whether PE was provoked by a major transient risk factor or not. A threshold at 41% was identified as the best value associated with the risk of recurrence 6 months after stopping anticoagulation (area under curve = 0.64). Conclusion PVOI ≥ 40% at PE diagnosis was an independent risk factor for recurrence VTE. Further prospective validation studies are needed.


BMJ ◽  
2012 ◽  
Vol 345 (oct04 2) ◽  
pp. e6564-e6564 ◽  
Author(s):  
G.-J. Geersing ◽  
P. M. G. Erkens ◽  
W. A. M. Lucassen ◽  
H. R. Buller ◽  
H. t. Cate ◽  
...  

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