Are Meteorological Parameters a Risk Factor for Pulmonary Embolism? A Retrospective Analysis of 530 Patients

The retrospective analysis of 22 patients’ clinical records with the verified pulmonary artery thromboembolism (PE) with various outcomes of a disease is carried out. Hypodiagnostics of PE at a pre-hospital stage is revealed, the predictive importance of Revised Geneva Score scale is shown, predictors of a lethal outcome at a PE are defined: arterial hypotension, tachycardia, McGinn-White syndrome (SI-QIII phenomenon).

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Abstract TP238: Encephalopathy Only Stroke Codes (EoSC) Do Not Result in rt-PA Treatments

Stroke ◽

10.1161/str.51.suppl_1.tp238 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Patrick Chen ◽

Dawn Meyer ◽

Brett Meyer

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Acute Stroke ◽

Retrospective Analysis ◽

Thrombolytic Treatment ◽

Knowing That ◽

History Of ◽

Demographic Risk ◽

To Receive ◽

Demographic Risk Factor

Background: Isolated mental status changes as presenting sign (EoSC+), are not uncommon stroke code triggers. As stroke alerts, they still require the same intensive resources be applied. We previously showed that EoSC+ strokes (EoSC+CVA+) account for 8-9% of EoSC+ codes but only 0.1-0.2% of all codes. Whether these result in thrombolytic treatment (rt-PA), and the characteristics/ risk factor profiles of EoSC+CVA+ patients, have not been reported. Methods: Retrospective analysis of stroke codes from an IRB approved registry, from 2004 to 2018, was performed. EoSC+ definition used was consistent with prior publications (NIHSS>0 for Q1a, 1b, or 1c with remaining elements scored 0). Other definitions were also assessed. Characteristics and risk factors were compared for EoSC+, EoSC+CVA+, and rt-PA (EoSC+ CVA+TPA+) patients. Results: EoSC+ occurred in 59/2982 (1.98%) of all stroke codes. EoSC+CVA+ occurred in 8/59 (13.56%) of EoSC+ codes and 8/2982 (0.27%) of all stroke codes. 6/8 (75%) of EoSC+CVA+ scored NIHSS=1. Hispanic ethnicity (p=0.009), HTN (p=0.02), and history of stroke/TIA (p=0.002) were less common in EoSC+. No demographic/ risk factor differences were noted for [EoSC+CVA+ vs. EoSC+CVA-]. No cases of rt-PA eligibility/ treatment were noted. In EoSC+CVA+ analysis, imaging positive stroke/intracranial hemorrhage was noted on only 3 cases (3/2982=0.10% of all stroke codes) and none were posterior stroke. Conclusions: EoSC+ is not an uncommon reason to activate stroke codes, but rarely results in stroke/TIA (0.27%) or stroke (0.10%), and in our analysis never (0%) resulted in rt-PA. Sub-analysis did not show missed rt-PA or posterior strokes. This adds information for application of limited acute stroke code resources. Though stroke codes must still to be activated, understanding characteristics, and knowing that EoSC+CVA+ patients are unlikely to receive rt-PA, may help triage stroke resources. Further investigation is warranted.

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Abstract P673: The Obesity Paradox in Patients Hospitalized for Ischemic Stroke

Stroke ◽

10.1161/str.52.suppl_1.p673 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Genaro Velazquez ◽

Hafeez Shaka ◽

Hernan G. Marcos-Abdala ◽

Emmanuel Akuna

Keyword(s):

Pulmonary Embolism ◽

Risk Factor ◽

Ischemic Stroke ◽

Respiratory Failure ◽

Hospital Mortality ◽

Odds Ratio ◽

Mechanical Thrombectomy ◽

Length Of Hospital Stay ◽

Obesity Paradox ◽

Secondary Outcomes

Introduction: Even though Obesity, as measured by BMI > 30.00 kg/m 2 , is a established risk factor for ASCVD, it hasn’t been proven as a risk factor for adverse outcomes in patients with diagnosis of ischemic stroke. Our study sought to compare outcomes for ischemic stroke hospitalizations in patients with and without Obesity. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. About 71,473,874who had ischemic stroke as primary diagnosis were enrolled and further stratified based on the presence or absence of Obesity as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, treatment with mechanical thrombectomy, treatment with tPA, and complications like respiratory failure requiring intubation, pulmonary embolism (PE), DVT, NSTEMI and sepsis. Multivariate regression analysis was done to adjust for confounders. Results: The in-hospital mortality for patients with ischemic stroke was 42 145 overall. Compared with patients without obesity, patients with Obesity had a lower odds of in- hospital mortality (aOR 0.85, 95% CI 0.79-0.93, p<0.001) when adjusted for patient and hospital characteristics. We found that patients with ischemic stroke and obesity had decreased length of hospital stay and higher odds ratio of treatment with mechanical thrombectomy, treatment with tPA, and higher odds ratio of complications like respiratory failure requiring intubation and pulmonary embolism (PE). No significant difference in other secondary outcomes (DVT, NSTEMI and sepsis). Conclusion: There is convincing evidence supporting the existence of the “obesity paradox” in patients with ischemic stroke. Several stroke-associated mechanisms, like autonomous nervous activation and pro-inflammatory cytokine release in addition to other factors like impaired feeding and inactivity cause accelerated tissue degradation and overall weight loss. It is thought that obese patients with better metabolic reserve may be less affected from this unfavorable metabolic dysregulation as compared to underweight patients. Nevertheless, further studies are needed in order to identify factors responsible for this paradox.

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Usefulness of CT Abdomen and Pelvis to Exclude Malignancy in Patients with Pulmonary Embolism (PE) Diagnosed on CTPA: A Retrospective Analysis

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a6583 ◽

2020 ◽

Author(s):

A.B. Afzal ◽

K. Heyes ◽

S. Baksi ◽

S. Khalid

Keyword(s):

Pulmonary Embolism ◽

Retrospective Analysis

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Asymptomatic venous thrombosis in cancer patients – a problem often overlooked. Results of a retrospective and prospective study

VASA ◽

10.1024/0301-1526.38.2.160 ◽

2009 ◽

Vol 38 (2) ◽

pp. 160-166 ◽

Cited By ~ 17

Author(s):

Heidrich ◽

Konau ◽

Hesse

Keyword(s):

Pulmonary Embolism ◽

Prospective Study ◽

Venous Thrombosis ◽

Retrospective Analysis ◽

Causes Of Death ◽

Duplex Sonography ◽

Systematic Screening ◽

Surgical Interventions ◽

Regular Screening ◽

Venous Thromboses

Background: Venous thrombosis with and without pulmonary embolism is a frequent complication of malignancies and second among the causes of death in tumour patients. Its incidence is reported to be 10 to 15%. Since for methodological reasons, this rate can be assumed to be too low and to disregard asymptomatic venous thrombosis, a combined retrospective and prospective study was performed to examine the actual frequency of venous thrombosis in tumour patients. Patients and methods: The histories of 409 patients (175 women, 234 men, mean age 69 years [19 to 96 years]) with different tumours, consecutively enrolled in the order of their altogether 426 inpatient treatments, were checked in retrospect for the frequency of venous thrombosis and pulmonary embolism. Subsequently, 97 tumour inpatients (36 women, 61 men, mean age 70 years [42 to 90 years]) were systematically screened, by means of duplex sonography and/or venography, for venous thromboses in the veins of the pelvis and both legs. Results: In the retrospective analysis, where no systematic screening for thromboses was performed and only symptomatic thrombosis was recorded, venous thrombosis was found in 6.6% of all tumour patients, whereas in the prospective examination with systematic duplex sonography and / or venography of all patients, the percentage was 33%. In the prospective study, 31.3% of venous thromboses were symptomatic and 68.7% asymptomatic. In 39.3% of the cases in the retrospective analysis and 25% in the prospective analysis, venous thrombosis occurred during chemotherapy, surgery or radiation therapy. Venous thrombosis was most often seen in metastasizing tumours and in colorectal carcinoma (40%), haematological system diseases (28.6%), gastric cancer (30%), bronchial, pancreas and ovarian carcinoma (28.6%), and carcinoma of the prostate (16.7%). Conclusion: Regular screening for thrombosis is indicated even in asymptomatic tumour patients because asymptomatic venous thrombosis is frequent, can lead to pulmonary embolism and has to be treated like symptomatic venous thrombosis. This is particularly true for metastasization during chemotherapy, surgical interventions, or radiation.

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