Review of outcomes and treatments of pulmonary embolism (PE)
Abstract
Introduction: Pulmonary embolism (PE) is a life-threatening medical condition associated with increased risk of cardiovascular fatalities. The keystone treatment for PE is anticoagulation; however, this comes with an increased risk of bleeding. Moreover, untreated prolonged PE can lead to increased right heart strain and right ventricle dysfunction known as cor pulmonale. In addition to anticoagulation, there are surgical interventions that are used on patients based on risk stratification from PESI score criteria. Although each PE treatment strategy has shown to be effective to some degree, there is still limited data on how each approach compares. The goal of this study is to evaluate the outcomes of treatment options for patients with PE.
Methods: A Retrospective chart review will be performed of all patients gathered by Sentara Health Research Center utilizing Sentara's Data Research Request Form; collected on the PE treatment success and patient outcomes. Statistical analysis was performed by using REDCap.
Results: Upon review of 40 charts, it was found that 7 (17.5 %) patients were found to have an elevated troponin trending up, 4 (10%) had a troponin trending low and 2 (5%) had a stable troponin. Post-intervention troponin showed that 3 (7.5 %) patients were found to have an elevated troponin trending up, 7 (17.5%) had a troponin trending low and 2 (7.5%) had a stable troponin. While more data is required to determine statistical significance, post-intervention troponin levels were trending lower, and we were unable to determine data for 27 charts. Of the 40 charts reviewed, 26 (65%) received Anticoagulation only, 3 (7.5%) received systemic thrombolysis, 7 (17.5%) received catheter-directed lysis, and 4 (10%) received mechanical thrombectomy. Moreover, 1 (2.5%) chart showed a patient who passed away at time of discharge or 7 days post intervention.
Conclusion: Using an ANOVA test after gathering more data will be helpful in determining a statistical significance in the troponin differences before and after intervention. Moreover, data shows that there is a relatively even distribution among the procedures that patients receive. Analyzing further data will be helpful to determine any significant differences in interventional procedures.