RT Journal Article
SR Electronic
T1 Massive and sub-massive pulmonary embolism (PE) long-term follow up data: Is there a need for dedicated PE clinics?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3127
DO 10.1183/13993003.congress-2018.PA3127
VO 52
IS suppl 62
A1 Abdullah Abbasi
A1 Muhammad Ganaie
A1 Sannaan Irshad
A1 Syeda Adil
A1 Mohammed Haris
A1 Muhammad Iqbal
YR 2018
UL http://erj.ersjournals.com/content/52/suppl_62/PA3127.abstract
AB Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is rare with an incidence of 0.1-9.1% within 2 years after PE. Routine screening for CTEPH after PE is not supported by evidence.Aim: We looked at long-term outcomes of massive (MPE) and sub-massive (SMPE) PE.Methods: We reviewed 4 years follow up data of MPE and SMPE presenting to University Hospitals of North Midlands from 01/01/2013 – 01/01/2014. Patients were risk stratified as per American Heart Association guidelines.Results: 275 patients presented with PE; 29 passed away within 3 months and were excluded from analysis. 84/246 (34%) had unprovoked PE (11 MPE [13%], 29 SMPE [35%]) and 162/246 (66%) had provoked PE (19 MPE [12%], 49 SMPE [30%]). All 30 MPE but none of the 78 SMPE patients were thrombolysed.4/11 unprovoked and 11/19 provoked MPE patients were followed up in clinic with echocardiogram. 2 patients developed CTEPH, one was managed conservatively due to co-morbidities and other refused further work-up.16/29 unprovoked and 34/49 provoked SMPE patients were followed up in clinic (only 22/34 provoked SMPE patients had echocardiogram). 2 patients developed CTEPH; one was managed conservatively due to co-morbidities and other was referred for pulmonary endarterectomy (none in provoked SMPE group).In our cohort of MPE and SMPE patients, 4/65 (6%) followed up patients developed CTEPH but the incidence could be higher as 43 patients were lost to follow up.Conclusion: CTEPH is a potentially curable condition with higher risk in large, recurrent or unprovoked PE. Dedicated PE clinics would facilitate smooth transition of patients from hospital to home, while maintaining regular follow-up.FootnotesCite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA3127.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).