Clinical characterization, risk factors, and evolution of pulmonary thromboembolism A single-center retrospective observational study.

Abstract

Introduction: Pulmonary thromboembolism (PTE) has a high mortality rate. It is characterized by the blockage of a pulmonary artery or its branches by a thrombus that migrates from another location. Because of its wide range of clinical manifestations, careful analysis is necessary for early diagnosis and prompt treatment. The aim of this study was to describe the background, clinical features, management, and progression of a group of patients diagnosed with PE admitted to a private referral center.

Materials and Methods: This is a descriptive, observational, retrospective, single-center study in which the medical records of 17 patients admitted to Alcívar Hospital between January 2022 and June 2024 with a diagnosis of pulmonary thromboembolism were analyzed.

Results: 17 patients (12 men, 70%), with a mean age of 62.8 years. Mortality was 47.05%. The most representative risk factors were hypertension (52.94%), recent surgery (47.07%), and heart disease and COVID (41.17%). The main signs and symptoms were: dyspnea, tachypnea, and oxygen desaturation (100%), tachycardia (88%), chest pain (82%), altered consciousness and cough (64.70%), hemoptysis (11%), hypotension, and fever (52.94%). The scales applied were the Wells scale, in which 47.05% had moderate risk and 41.17% had a high risk of suffering from PTE; on the PESI scale, 88.93% were at high risk. DIMER D had a mean value of 8579.82 ng/mL and troponin T, 98.52 ng/L. Anticoagulation treatment was with sodium heparin in 29.4 % and LMWH in 70.58 %, in addition, thrombectomy (23.52 %) and inferior vena cava filter implantation (41.17 %) were performed.

Conclusions: Risk factors for developing PE are important for suspecting this condition; in this study, the main cardiovascular factors, previous surgeries, and trauma were identified. The clinical presentation varies widely, from mild signs and symptoms to more suggestive indicators such as dyspnea, tachypnea, desaturation, chest pain, and tachycardia. Some scales assist in diagnosis and prognosis, which, together with clinical assessments and additional tests, enable early and timely treatment to reduce complications and mortality. However, as shown in this study, despite early diagnosis and adequate combined treatment, the mortality rate remains high, as noted in the literature.