Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
June-2015 Volume 9 Issue 6

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
June-2015 Volume 9 Issue 6

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article

Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism

  • Authors:
    • Joachim Gruettner
    • Tim Viergutz
    • Merle Bolte
    • Thomas Henzler
    • Stefan O. Schoenberg
    • Sonja Sudarski
    • Paul Apfaltrer
    • Thomas Walter
  • View Affiliations / Copyright

    Affiliations: Emergency Department, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg D-68167, Germany, Clinic for Anesthesiology and Operative Intensive Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg D-68167, Germany, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg D-68167, Germany
  • Pages: 2281-2284
    |
    Published online on: March 30, 2015
       https://doi.org/10.3892/etm.2015.2395
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

The reliable exclusion of a pulmonary embolism (PE) in hemodynamically stable patients remains a challenge. The European Society of Cardiology guidelines for PE diagnosis published in 2008 and updated in 2014 recommend a low-threshold computed tomography (CT) indication for patients with a high probability of pulmonary embolism or those with elevated levels of D-dimers. Certain elements of the recommendations are controversial, while others, including the evaluation of the risk factors for PE, are considered only in individual cases. In the present study, various risk factors, including obesity, smoking, contraceptive use, immobility level, history of malignant disease and thrombophilia and the factors of familial predisposition, deep vein thrombosis (DVT)/PE‑history, long‑distance flying <1 week and surgery <4 weeks previously, were retrospectively examined in 492 patients with a suspected PE. The data demonstrated a significant risk of PE with contraceptive use, a history of DVT/PE and thrombophilia. The immobility level, surgery <4 weeks and long‑distance flying <1 week previously, as well as family history, malignant disease, obesity and smoking, were not observed to be associated with a significantly higher risk of PE. Contraceptive use and thrombophilia, in addition to a history of DVT/PE, each appear to have a significant predictive value in the context of PE risk stratification. Therefore, patients with a suspected PE, who additionally present with at least one of the aforementioned risk factors, should undergo further diagnostic steps for PE risk stratification, including a low‑threshold CT examination, even in the absence of elevated D-dimers.
View Figures

Figure 1

View References

1 

Walther A and Böttiger BW: Pulmonary embolism. Wien Med Wochenschr. 158:610–614. 2008.[(In German)]. View Article : Google Scholar : PubMed/NCBI

2 

Horlander KT, Mannino DM and Leeper KV: Pulmonary embolism mortality in the United States, 1979–1998: an analysis using multiple-cause mortality data. Arch Intern Med. 163:1711–1717. 2003. View Article : Google Scholar : PubMed/NCBI

3 

Goldhaber SZ: Pulmonary embolism. Lancet. 363:1295–1305. 2004. View Article : Google Scholar : PubMed/NCBI

4 

Kline JA, Hernandez-Nino J, Jones AE, Rose GA, Norton HJ and Camargo CA Jr: Prospective study of the clinical features and outcomes of emergency department patients with delayed diagnosis of pulmonary embolism. Acad Emerg Med. 14:592–598. 2007. View Article : Google Scholar : PubMed/NCBI

5 

Mullins MD, Becker DM, Hagspiel KD and Philbrick JT: The role of spiral volumetric computed tomography in the diagnosis of pulmonary embolism. Arch Intern Med. 160:293–298. 2000. View Article : Google Scholar : PubMed/NCBI

6 

Perrier A, Howarth N, Didier D, et al: Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism. Ann Intern Med. 135:88–97. 2001. View Article : Google Scholar : PubMed/NCBI

7 

Torbicki A, Perrier A, Konstantinides S, et al: ESC Committee for Practice Guidelines (CPG): Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J. 29:2276–2315. 2008. View Article : Google Scholar : PubMed/NCBI

8 

Douma RA, Mos IC, Erkens PM, et al: Performance of 4 clinical decision rules in the diagnostic management of acute pulmonary embolism: a prospective cohort study. Ann Intern Med. 154:709–718. 2011. View Article : Google Scholar : PubMed/NCBI

9 

Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H and Perrier A: Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 144:165–171. 2006. View Article : Google Scholar : PubMed/NCBI

10 

Wells PS, Anderson DR, Rodger M, et al: Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 83:416–420. 2000.PubMed/NCBI

11 

Young MD, Daniels AH, Evangelista PT, et al: Predicting pulmonary embolus in orthopedic trauma patients using the wells score. Orthopedics. 36:e642–e647. 2013. View Article : Google Scholar : PubMed/NCBI

12 

Gruettner J, Walter T, Bolte M, Haghi D, Sudarski S and Henzler T: Incidence of pulmonary embolism in an emergency department cohort evaluated with a simple symptom-based diagnostic algorithm. In Vivo. 27:215–220. 2013.PubMed/NCBI

13 

Calvo-Romero JM, Pérez-Miranda M and Bureo-Dacal P: Syncope in acute pulmonary embolism. Eur J Emerg Med. 11:208–209. 2004. View Article : Google Scholar : PubMed/NCBI

14 

Castelli R, Tarsia P, Tantardini C, Pantaleo G, Guariglia A and Porro F: Syncope in patients with pulmonary embolism: comparison between patients with syncope as the presenting symptom of pulmonary embolism and patients with pulmonary embolism without syncope. Vasc Med. 8:257–261. 2003. View Article : Google Scholar : PubMed/NCBI

15 

Koutkia P and Wachtel TJ: Pulmonary embolism presenting as syncope: case report and review of the literature. Heart Lung. 28:342–347. 1999. View Article : Google Scholar : PubMed/NCBI

16 

Miniati M, Prediletto R, Formichi B, et al: Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med. 159:864–871. 1999. View Article : Google Scholar : PubMed/NCBI

17 

Wolfe TR and Allen TL: Syncope as an emergency department presentation of pulmonary embolism. J Emerg Med. 16:27–31. 1998. View Article : Google Scholar : PubMed/NCBI

18 

Goldhaber SZ, Grodstein F, Stampfer MJ, et al: A prospective study of risk factors for pulmonary embolism in women. JAMA. 277:642–645. 1997. View Article : Google Scholar : PubMed/NCBI

19 

Kline JA and Miller DW: Risk stratification for acute pulmonary embolism. J Natl Compr Canc Netw. 9:800–810. 2011.PubMed/NCBI

20 

Lauque D, Mazières J, Rouzaud P, et al: Pulmonary embolism in patients using estrogen-progestagen contraceptives. Presse Med. 27:1566–1569. 1998.[(In French)]. PubMed/NCBI

21 

Lehmann R, Suess C, Leus M, et al: Incidence, clinical characteristics and long-term prognosis of travel-associated pulmonary embolism. Eur Heart J. 30:233–241. 2009. View Article : Google Scholar : PubMed/NCBI

22 

Antman EM, Cohen M, Bernink PJ, et al: The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. JAMA. 284:835–842. 2000. View Article : Google Scholar : PubMed/NCBI

23 

Manzoli L, De Vito C, Marzuillo C, Boccia A and Villari P: Oral contraceptives and venous thromboembolism: a systematic review and meta-analysis. Drug Saf. 35:191–205. 2012.PubMed/NCBI

24 

Wu O, Robertson L, Twaddle S, et al: Screening for thrombophilia in high-risk situations: systematic review and cost-effectiveness analysis. The thrombosis: risk and economic assessment of thrombophilia screening (TREATS) study. Health Technol Assess. 10:100–110. 2006. View Article : Google Scholar

25 

Breen ME, Dorfman M and Chan SB: Pulmonary embolism despite negative ELISA D-dimer: a case report. J Emerg Med. 37:290–292. 2009. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Gruettner J, Viergutz T, Bolte M, Henzler T, Schoenberg SO, Sudarski S, Apfaltrer P and Walter T: Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism. Exp Ther Med 9: 2281-2284, 2015.
APA
Gruettner, J., Viergutz, T., Bolte, M., Henzler, T., Schoenberg, S.O., Sudarski, S. ... Walter, T. (2015). Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism. Experimental and Therapeutic Medicine, 9, 2281-2284. https://doi.org/10.3892/etm.2015.2395
MLA
Gruettner, J., Viergutz, T., Bolte, M., Henzler, T., Schoenberg, S. O., Sudarski, S., Apfaltrer, P., Walter, T."Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism". Experimental and Therapeutic Medicine 9.6 (2015): 2281-2284.
Chicago
Gruettner, J., Viergutz, T., Bolte, M., Henzler, T., Schoenberg, S. O., Sudarski, S., Apfaltrer, P., Walter, T."Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism". Experimental and Therapeutic Medicine 9, no. 6 (2015): 2281-2284. https://doi.org/10.3892/etm.2015.2395
Copy and paste a formatted citation
x
Spandidos Publications style
Gruettner J, Viergutz T, Bolte M, Henzler T, Schoenberg SO, Sudarski S, Apfaltrer P and Walter T: Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism. Exp Ther Med 9: 2281-2284, 2015.
APA
Gruettner, J., Viergutz, T., Bolte, M., Henzler, T., Schoenberg, S.O., Sudarski, S. ... Walter, T. (2015). Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism. Experimental and Therapeutic Medicine, 9, 2281-2284. https://doi.org/10.3892/etm.2015.2395
MLA
Gruettner, J., Viergutz, T., Bolte, M., Henzler, T., Schoenberg, S. O., Sudarski, S., Apfaltrer, P., Walter, T."Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism". Experimental and Therapeutic Medicine 9.6 (2015): 2281-2284.
Chicago
Gruettner, J., Viergutz, T., Bolte, M., Henzler, T., Schoenberg, S. O., Sudarski, S., Apfaltrer, P., Walter, T."Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism". Experimental and Therapeutic Medicine 9, no. 6 (2015): 2281-2284. https://doi.org/10.3892/etm.2015.2395
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team