Tuesday, July 06, 2010

Should all patients with PE be checked for concomitant DVT?

According to a recent study:

Conclusions: In patients with a first episode of acute symptomatic PE, the presence of concomitant DVT is an independent predictor of death in the ensuing 3 months after diagnosis. Assessment of the thrombotic burden should assist with risk stratification of patients with acute PE.

AT A GLANCE COMMENTARY

Scientific Knowledge on the Subject
Risk stratification of patients with pulmonary embolism may identify patients at high risk of early death who may benefit from more intensive surveillance or aggressive therapy. Alternatively, patients deemed low risk for early complications might be considered for partial or complete outpatient treatment of their pulmonary embolism.

What This Study Adds to the Field
In patients with a first episode of acute symptomatic pulmonary embolism, the presence of concomitant deep vein thrombosis is an independent predictor of death in the ensuing 3 months after diagnosis. This study validates the use of the lower extremity venous compression ultrasonography for prognostication and risk stratification of patients with acute symptomatic pulmonary embolism.

Traditionally we assess risk by evaluating right ventricular function, via biomarkers and echocardiography. Assessment for concomitant DVT may have a complementary role.

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