Circulation Journal
Clinical Investigation
Differences in Clinical Presentation of Pulmonary Embolism in Older vs Younger Patients
Nurdan KokturkI. Kivilcim OguzulgenNalan DemirKoray DemirelNuman Ekim
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Volume 69 (2005) Issue 8 Pages 981-986

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Abstract

Background In order to better define the clinical characterization of pulmonary embolism (PE) in the elderly, the clinical and laboratory findings were compared in older (≥65 years old) and younger (<65 years old) patients. Methods and Results The study group comprised 149 patients (58 older and 91 younger) who received a final diagnosis of PE and were retrospectively evaluated. The severity of PE was assessed by calculating the pulmonary vascular obstruction scores (PVOs) scintigraphically: PVOs ≥50% was defined as severe disease. Dyspnea was the most frequent symptom in both groups. Chest pain and hemoptysis were less frequent in older patients (48.3% vs 79.1%, p=0.001; 6.9% vs 20.9%, p=0.021, respectively) whereas syncope occurred more often in the older group (27.6% vs 9.9%, p=0.005). PVOs ≥50% occurred in 55.1% of older and 32.9% of younger patients (odds ratio: 1.67, 95%confidence interval: 1.118-2.507, p=0.013). Conclusions The clinical presentation of PE can be subtle or atypical in elderly patients and hence they may have more severe disease. Therefore, a high clinical suspicion is required in order to prevent delays in diagnostic work-up and initiation of appropriate treatment. (Circ J 2005; 69: 981 - 986)

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© 2005 THE JAPANESE CIRCULATION SOCIETY
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