Risk factors for presence and severity of pulmonary embolism in patients with deep venous thrombosis

Nancy Huynh, Wassim H. Fares, Kirstyn Brownson, Anand Brahmandam, Alfred I. Lee, Alan Dardik, Timur Sarac, Cassius Iyad Ochoa Chaar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objective The Caprini model estimates patients’ risk for venous thromboembolism by 30 different factors. Hemodynamically significant pulmonary embolism (PE), defined as high-risk (massive) or intermediate-risk (submassive) PE, has high morbidity and mortality rates. This study tests whether the Caprini model and deep venous thrombosis (DVT) characteristics correlate with the prevalence of PE and hemodynamically significant PE in patients with DVT. Methods A retrospective review of patients diagnosed with DVT between January 2013 and August 2014 in a tertiary care center was performed. Multivariable analysis was used to determine predictors of PE and hemodynamically significant PE. Results Of 838 consecutive patients with DVT, 217 (25.9%) had concomitant PE at presentation, of whom 135 had hemodynamically significant PE (101 submassive PE, 34 massive PE). The mean age was 65 years, and 51.0% were women. There was no significant relation between age or gender and the occurrence of PE or hemodynamically significant PE. Patients with PE were less likely to have undergone recent surgery (18.4% vs 30.3%; P =.001), to have sepsis (4.6% vs 11.8%; P =.002), and to have higher Caprini scores (6.1 vs 6.5; P =.047). Patients with DVT were less likely to have hemodynamically significant PE after recent surgery (13.3% vs 27.2%; P =.011) but more likely to have hemodynamically significant PE with proximal DVT (80.7% vs 64.2%). There was no association between Caprini score and hemodynamically significant PE (6.3 vs 5.7; P =.171). Conclusions The Caprini model has a poor association with PE or hemodynamically significant PE in patients with DVT. Among all patients with DVT, a concomitant diagnosis of PE or hemodynamically significant PE is less common in those with sepsis or undergoing recent surgery but more common in those with proximal DVT.

Original languageEnglish (US)
Pages (from-to)7-12
Number of pages6
JournalJournal of Vascular Surgery: Venous and Lymphatic Disorders
Volume6
Issue number1
DOIs
StatePublished - Jan 2018

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Risk factors for presence and severity of pulmonary embolism in patients with deep venous thrombosis'. Together they form a unique fingerprint.

Cite this