2002 Volume 13 Issue 1 Pages 29-33
We investigated the clinical characteristics and treatment of documented in-hospital acute pulmonary embolism (APE). Twenty-two of 71 consecutive APE patients treated in our hospital experienced in-hospital onset of APE (Group 1); onset in the remaining 49 occurred prior to admission (Group 2). Patients were treated with anticoagulation and thrombolytic therapy and temporary inferior vena cava filter implantation for secondary embolus prevention until they resumed daily activity. The mortality rate was 27.3% (6/22)in Group 1 and 16.3% (8/49) in Group 2. The 6 Group 1 patients died within 4 hours of APE onset, with 5 of the 6 dying within 1 hour of onset. Severe symptoms, such as cardiopulmonary arrest, shock, and syncope, occurred significantly more frequently in Group 1 patients (15/22, 68.2%) than in Group 2 patients (12/49, 24.5%). The 12 Group 1 patients experienced no prodromal episodes before the onset of severe symptoms. Thus, the physical condition of Group 1 patients deteriorated suddenly with the onset of APE, and most deaths in this group occurred just after APE onset. In conclusion, we strongly recommend that anticoagulation and thrombolytic therapy commence as soon as possible for patients suffering in hospital APE.
