Importancia pronóstica de la trombosis venosa profunda en pacientes diagnosticados de tromboembolismo pulmonar agudo

Resumen

Background: Concomitant deep vein thrombosis (DVT) in patients with acute pulmonary embolism (PE) has an uncertain prognostic significance. Knowing it better could help physicians assess the risks of patients with acute symptomatic pulmonary embolism and improve decision making about early hospital discharge and ambulatory treatment. Methods and results: This study included a total of 356 patients with objectively confirmed acute symptomatic PE at Hospital General Universitario de Alicante from January 1996 through December 2005. More than half were diagnosed with a concomitant DVT. Diagnosis of confirmed DVT associated to PE increased mortality by twice as much. Cancer raised the risk of death by a factor of four after the diagnosis of PE. Pulmonary infarction syndrome decreased the probability of death by around 67% and could be considered a protective factor. Conclusions: The presence of concomitant deep vein thrombosis is an independent predictor of death after diagnosis. This study validates the use of the lower extremity venous compression ultrasonography for prognostication and risk stratification of patients with acute symptomatic pulmonary embolism