The Evaluation of Cases Diagnosed as Acute Pulmonary Embolism in Emergency Department

Abstract

Introduction: Pulmonary embolism (PE) is an important clinical problem even the progression of diagnosis and treatment strategies. The aim of this study was to evaluate the risk factors, clinical characteristics and clinical outcome of patients with PE in emergency department. Materials and Methods: Charts of patients presenting with acute PE in our university hospital emergency department were reviewed retrospectively between January 2002 and January 2006. The demographic characteristics, physical examination findings, risk factors, diagnostic methods and clinical results of patients were evaluated. Results: There were 102 patients with acute PE. During the study period 0.15% of the cases admitted to the emergency department was found as Pulmonary embolism. Fifty-nine percent (58,8 %) of the cases (n=60) were female. Mean ages was 58, 5 +/- 15.5. The most frequent symptoms were dyspnea (79,4%), chest pain (58,8%), and cough (44, 1%) respectively. Rales (50%), tachypnea (44, 1%), and Homan's sign (34,4%) were physical examination findings. Older ages (55,9%), immobility (37,3%), smoking (32,4%) were found as risk factors. Infiltration (56,9%), cardiomegalia (34,3%), widening of the pulmonary artery (32,4%) were the findings of antero posterior lung X-ray. We have used spiral computerized tomography (77,5%) and lung ventilation-perfusion lung scanning (22,5%) in the checking of the diagnosis of PE. Twenty-two percent (21,6%) of the cases were massive PE, and remaining 78,4% were sub massive PE. Eighty-eight percent (87,3%) of the cases were received heparin and remaining 12,7% of the cases were received thrombolytic treatment. Conclusion: Dyspnea is the most frequent symptom of the cases with PE and PE is more common in older ages. Determination of clinical characteristics and risk factors of PE would help in decreasing mortality due to the PE in emergency service.