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Risk factors for pulmonary embolism in patients preliminarily diagnosed with community-acquired pneumonia: a prospective cohort study.
J Thromb Thrombolysis. 2016 May; 41(4):619-27.JT

Abstract

D-dimer levels are increased in patients with acute pulmonary embolism (PE). However, D-dimer levels are also increased in patients with community-acquired pneumonia (CAP). The aim of this prospective cohort study was to examine the incidence and clinical features of patients preliminarily diagnosed with CAP and with increased D-dimer levels, and who finally were diagnosed with PE. Patients diagnosed with CAP and hospitalized in the Respiratory Department of the Tenth People's Hospital Affiliated to Tongji University between May 2011 and May 2013 were enrolled. D-dimer levels were measured routinely after admission. For patients with increased D-dimer levels, those suspected with PE underwent computed tomography pulmonary angiography (CTPA). A total of 2387 patients with CAP was included: 724 (30.3 %) had increased D-dimer levels (median of 0.91 mg/L). CTPA was performed for 139 of the 724 patients (median D-dimer levels of 1.99 mg/L). Among the 139 patients, 80 were diagnosed with PE, and 59 without PE; D-dimer levels were 2.83 and 1.41 mg/L, respectively (p < 0.05). Multivariate analysis showed that age, coronary heart disease, chronic obstructive pulmonary disease (COPD), lower limb varicosity, chest pain, shortness of breath, hemoptysis, fever, and increased levels of troponin I were independent risk factors for PE. Presentation of PE and CAP are similar. Nevertheless, these results indicated that for hospitalized patients with CAP and elevated D-dimer levels, PE should be considered for those >60 years; with CHD, COPD, or lower limb varicosity; with chest pain, shortness of breath, hemoptysis, increased troponin I, or low fever.

Authors+Show Affiliations

Department of Respiratory Medicine, Shanghai Liqun Hospital, Putuo District, Shanghai, 200333, China.Department of Respiratory Medicine, Shanghai Liqun Hospital, Putuo District, Shanghai, 200333, China.Department of Respiratory Medicine, Shanghai Liqun Hospital, Putuo District, Shanghai, 200333, China.Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China.Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China.Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China.Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China.Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China. wangch061@sina.com.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26370200

Citation

Zhang, Yunfeng, et al. "Risk Factors for Pulmonary Embolism in Patients Preliminarily Diagnosed With Community-acquired Pneumonia: a Prospective Cohort Study." Journal of Thrombosis and Thrombolysis, vol. 41, no. 4, 2016, pp. 619-27.
Zhang Y, Zhou Q, Zou Y, et al. Risk factors for pulmonary embolism in patients preliminarily diagnosed with community-acquired pneumonia: a prospective cohort study. J Thromb Thrombolysis. 2016;41(4):619-27.
Zhang, Y., Zhou, Q., Zou, Y., Song, X., Xie, S., Tan, M., Zhang, G., & Wang, C. (2016). Risk factors for pulmonary embolism in patients preliminarily diagnosed with community-acquired pneumonia: a prospective cohort study. Journal of Thrombosis and Thrombolysis, 41(4), 619-27. https://doi.org/10.1007/s11239-015-1275-6
Zhang Y, et al. Risk Factors for Pulmonary Embolism in Patients Preliminarily Diagnosed With Community-acquired Pneumonia: a Prospective Cohort Study. J Thromb Thrombolysis. 2016;41(4):619-27. PubMed PMID: 26370200.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for pulmonary embolism in patients preliminarily diagnosed with community-acquired pneumonia: a prospective cohort study. AU - Zhang,Yunfeng, AU - Zhou,Qixing, AU - Zou,Ying, AU - Song,Xiaolian, AU - Xie,Shuanshuan, AU - Tan,Min, AU - Zhang,Guoliang, AU - Wang,Changhui, PY - 2015/9/16/entrez PY - 2015/9/16/pubmed PY - 2016/12/15/medline KW - Community-acquired pneumonia KW - Complications KW - D-dimer KW - Prospective cohort study KW - Pulmonary thromboembolism KW - Risk factors SP - 619 EP - 27 JF - Journal of thrombosis and thrombolysis JO - J Thromb Thrombolysis VL - 41 IS - 4 N2 - D-dimer levels are increased in patients with acute pulmonary embolism (PE). However, D-dimer levels are also increased in patients with community-acquired pneumonia (CAP). The aim of this prospective cohort study was to examine the incidence and clinical features of patients preliminarily diagnosed with CAP and with increased D-dimer levels, and who finally were diagnosed with PE. Patients diagnosed with CAP and hospitalized in the Respiratory Department of the Tenth People's Hospital Affiliated to Tongji University between May 2011 and May 2013 were enrolled. D-dimer levels were measured routinely after admission. For patients with increased D-dimer levels, those suspected with PE underwent computed tomography pulmonary angiography (CTPA). A total of 2387 patients with CAP was included: 724 (30.3 %) had increased D-dimer levels (median of 0.91 mg/L). CTPA was performed for 139 of the 724 patients (median D-dimer levels of 1.99 mg/L). Among the 139 patients, 80 were diagnosed with PE, and 59 without PE; D-dimer levels were 2.83 and 1.41 mg/L, respectively (p < 0.05). Multivariate analysis showed that age, coronary heart disease, chronic obstructive pulmonary disease (COPD), lower limb varicosity, chest pain, shortness of breath, hemoptysis, fever, and increased levels of troponin I were independent risk factors for PE. Presentation of PE and CAP are similar. Nevertheless, these results indicated that for hospitalized patients with CAP and elevated D-dimer levels, PE should be considered for those >60 years; with CHD, COPD, or lower limb varicosity; with chest pain, shortness of breath, hemoptysis, increased troponin I, or low fever. SN - 1573-742X UR - https://www.unboundmedicine.com/medline/citation/26370200/Risk_factors_for_pulmonary_embolism_in_patients_preliminarily_diagnosed_with_community_acquired_pneumonia:_a_prospective_cohort_study_ L2 - https://doi.org/10.1007/s11239-015-1275-6 DB - PRIME DP - Unbound Medicine ER -