Abstract
Aims: There is a clinical equipoise regarding the management of patients with isolated-subsegmental-pulmonary-embolism (SSPE). This study compared clinical outcomes of hospitalised patients with SSPE diagnosed on computed-tomography-pulmonary-angiogram (CTPA) with those with a more proximal pulmonary embolism (PE).
Methods: All patients with a positive CTPA for PE admitted between 2017-2021 at two tertiary hospitals in Australia were included in this study. Patients with an Isolated SSPE, defined as single or multiple filling defects localised at the level of subsegmental pulmonary arteries, were compared to those with a more proximal PE. The primary outcome was the cumulative incidence of recurrent venous thromboembolism (VTE) within 3 months and 1 year following the date of index event. The secondary outcome was overall mortality at 1 year of index event for the two groups. Competing risk analysis and Cox-proportional hazard models were used to compare VTE risk and mortality among patients with SSPE compared to those with proximal PE.
Results: Of 334 patients with a positive CTPA for PE, 111 (33.2%) had isolated SSPE. The mean (SD) age was 64.3 (17.7) years, 50.9% were males and 9.6% were identified as frail. The clinical presentation of PE was similar between the two groups, apart from history of dyspnoea which was less common among patients with isolated SSPE when compared to more proximal PE (P=0.026). Between patients with isolated SSPE and those with a more proximal PE, the risk of recurrent VTE within 3-months (0.9% vs. 1.8%, P=.458) and within 1-year of follow-up (2.7% vs. 6.3%, P=.126) did not differ significantly. Similarly, mortality within 1 year of index event was also not different between the two groups (Hazard ratio (HR) 1.72, 95% CI 0.92-3.21, P>0.05)
Conclusions: The prevalence of SSPE was 33.2% and these patients had clinical outcomes that did not differ from those with proximal PE.
Methods: All patients with a positive CTPA for PE admitted between 2017-2021 at two tertiary hospitals in Australia were included in this study. Patients with an Isolated SSPE, defined as single or multiple filling defects localised at the level of subsegmental pulmonary arteries, were compared to those with a more proximal PE. The primary outcome was the cumulative incidence of recurrent venous thromboembolism (VTE) within 3 months and 1 year following the date of index event. The secondary outcome was overall mortality at 1 year of index event for the two groups. Competing risk analysis and Cox-proportional hazard models were used to compare VTE risk and mortality among patients with SSPE compared to those with proximal PE.
Results: Of 334 patients with a positive CTPA for PE, 111 (33.2%) had isolated SSPE. The mean (SD) age was 64.3 (17.7) years, 50.9% were males and 9.6% were identified as frail. The clinical presentation of PE was similar between the two groups, apart from history of dyspnoea which was less common among patients with isolated SSPE when compared to more proximal PE (P=0.026). Between patients with isolated SSPE and those with a more proximal PE, the risk of recurrent VTE within 3-months (0.9% vs. 1.8%, P=.458) and within 1-year of follow-up (2.7% vs. 6.3%, P=.126) did not differ significantly. Similarly, mortality within 1 year of index event was also not different between the two groups (Hazard ratio (HR) 1.72, 95% CI 0.92-3.21, P>0.05)
Conclusions: The prevalence of SSPE was 33.2% and these patients had clinical outcomes that did not differ from those with proximal PE.
| Original language | English |
|---|---|
| Number of pages | 1 |
| Publication status | Published - 28 Feb 2024 |
| Event | IMSANZ'24 - New Plymouth, New Plymouth, New Zealand Duration: 28 Feb 2024 → 1 Mar 2024 |
Conference
| Conference | IMSANZ'24 |
|---|---|
| Country/Territory | New Zealand |
| City | New Plymouth |
| Period | 28/02/24 → 1/03/24 |
| Other | As clinicians we value ‘kanohi ki te kanohi’ or face-to-face communication and understand that our conferences are more than a series of lectures; they are also a chance to network, share experiences and engage in informal social activities with both new and long-standing colleagues. In 2024, the IMSANZ NZ Conference will continue to be presented in a ‘Hybrid’ format, however ALL presentations will be in-person. The conference will be held in New Plymouth, with plenty of onsite accommodation. We will be providing a raft of local social activities and outdoor experiences that will make the event even more enticing. |
Bibliographical note
Poster presentation, Thursday February 29, 2024, 12:45 pm - 1:15 pm.Keywords
- Pulmonary embolism (PE)
- Isolated subsegmental pulmonary embolism (SSPE)
- Patients