Trends in the Management and Outcomes of Acute Pulmonary Embolism: Analysis From the RIETE Registry.

Détails

ID Serval
serval:BIB_2A7244D705DD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Trends in the Management and Outcomes of Acute Pulmonary Embolism: Analysis From the RIETE Registry.
Périodique
Journal of the American College of Cardiology
Auteur⸱e⸱s
Jiménez D., de Miguel-Díez J., Guijarro R., Trujillo-Santos J., Otero R., Barba R., Muriel A., Meyer G., Yusen R.D., Monreal M.
Collaborateur⸱rice⸱s
RIETE Investigators
Contributeur⸱rice⸱s
Monreal M., Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Bertoletti L., Schellong S., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R., Wells P., Papadakis M., Adarraga M.D., Arcelus J.I., Auguet T., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Cámara T., Casado I., de Miguel J., del Molino F., del Toro J., Díaz J.A., Falgá C., Fernández-Capitán C., Font L., Gallego P., García-Bragado F., Gómez V., González J., Grau E., Guijarro R., Guirado L., Gutiérrez J., Hernández-Blasco L., Hernández-Huerta D., Jara-Palomares L., Jaras M.J., Jiménez D., Lacruz B., Lecumberri R., Lobo J.L., López-Dupla M., López-Jiménez L., López-Reyes R., López-Sáez J.B., Lorente M.A., Lorenzo A., Madridano O., Maestre A., Marchena P.J., Martín-Antorán J.M., Martín-Martos F., Monreal M., Morales M.V., Nauffal D., Nieto J.A., Núñez M.J., Otero R., Pagán B., Pedrajas J.M., Pérez G., Peris M.L., Ponce de León L., Pons I., Porras J.A., Riera-Mestre A., Rivas A., Rodríguez-Dávila M.A., Rosa V., Ruiz-Giménez N., Sampériz A., Sánchez R., Sanz O., Soler S., Suarez-Lorenzo I., Suriñach J.M., Tiberio G., Tolosa C., Trujillo-Santos J., Uresandi F., Valero B., Valle R., Vela J., Vela L., Vidal G., Villalobos A., Villalta J., Vanassche T., Verhamme P., Wells P., Hirmerova J., Malý R., Tomko T., Salgado E., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Hij A., Mahé I., Merah A., Moustafa F., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Apollonio A., Barillari G., Bucherini E., Ciammaichella M., De Ciantis P., Di Micco P., Ferrazzi P., Lodigiani C., Maida R., Mastroiacovo D., Pace F., Pasca S., Pesavento R., Pinelli M., Piovella C., Prandoni P., Rota L., Tiraferri E., Tonello D., Tufano A., Visonà A., Zalunardo B., Drucka E., Kigitovica D., Skride A., Dias C., Ribeiro J.L., Sousa M.S., Bosevski M., Alatri A., Bounameaux H., Calanca L., Mazzolai L.
ISSN
1558-3597 (Electronic)
ISSN-L
0735-1097
Statut éditorial
Publié
Date de publication
19/01/2016
Volume
67
Numéro
2
Pages
162-170
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Despite advances in hospital management in recent years, it is not clear whether mortality after acute pulmonary embolism (PE) has decreased over time.
This study describes the trends in the management and outcomes of acute symptomatic PE.
We identified adults with acute PE enrolled in the registry between 2001 and 2013. We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies. Using multivariable regression, we examined temporal trends in risk-adjusted rates of all-cause and PE-related death to 30 days after diagnosis.
Among 23,858 patients with PE, mean length of stay decreased from 13.6 to 9.3 days over time (32% relative reduction, p < 0.001). For initial treatment, use of low-molecular-weight heparin increased from 77% to 84%, whereas the use of unfractionated heparin decreased from 22% to 8.4% (p < 0.001 for trend for all comparisons). Thrombolytic therapy use increased from 0.7% to 1.0% (p = 0.07 for trend) and surgical embolectomy use doubled from 0.3% to 0.6% (p < 0.01 for trend). Risk-adjusted rates of all-cause mortality decreased from 6.6% in the first period (2001 to 2005) to 4.9% in the last period (2010 to 2013) (p = 0.02 for trend). Rates of PE-related mortality decreased over time, with a risk-adjusted rate of 3.3% in 2001 to 2005 and 1.8% in 2010 to 2013 (p < 0.01 for trend).
In a large international registry of patients with PE, improvements in length of stay and changes in the initial treatment were accompanied by a reduction in short-term all-cause and PE-specific mortality.

Mots-clé
Acute Disease, Aged, Aged, 80 and over, Disease Management, Female, Fibrinolytic Agents/therapeutic use, Heparin, Low-Molecular-Weight/therapeutic use, Humans, Length of Stay, Male, Middle Aged, Outcome and Process Assessment (Health Care), Prognosis, Pulmonary Embolism/diagnosis, Pulmonary Embolism/epidemiology, Pulmonary Embolism/therapy, Risk Assessment, Spain/epidemiology, Survival Analysis, Thrombectomy/methods, Thrombectomy/statistics & numerical data, Thrombolytic Therapy/methods, Thrombolytic Therapy/statistics & numerical data
Pubmed
Open Access
Oui
Création de la notice
21/02/2017 12:48
Dernière modification de la notice
20/08/2019 14:10
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