Abstract
Background: It has been speculated that the atypical clinical presentation of acute pulmonary embolism (PE) in older patients leads to a delay in diagnosis and therefore contributes to the worse prognosis of older patients presenting with acute PE.
Methods: In this single-centre study we investigated the delay in diagnosis and its relation with in-hospital mortality in 202 consecutive patients with acute PE in a period of 14 months. The study population was divided in a younger (≤ 65 years) and an older age group (> 65 years).
Results: Older patients present more often hypoxic (p = 0.017) and with a history of syncope (p = 0.046) than younger patients. Delay in diagnosis was not statistically different in both age groups (3.1±3.0 days in the younger and 3.5±3.1 days in the older age group, p = 0.450). Age above 65 years was significantly associated with an increased risk for in-hospital mortality (OR 4.36, 95% CI 0.93-20.37, p = 0.043). Delay in diagnosis was not associated with an increase of in-hospital mortality in univariate or multivariate analysis.
Conclusions: The atypical clinical presentation of acute PE in patients older than 65 years cannot be considered as a risk factor for late diagnosis. Moreover, delay in diagnosis is not related to the higher in-hospital death rate of older patients suffering from acute PE.
- © 2011 ERS
