Acute Cardiac Disorder or Pneumonia and Concomitant Presence of Pulmonary Embolism 英文参考文献.docVIP
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Acute Cardiac Disorder or Pneumonia and Concomitant Presence of Pulmonary Embolism 英文参考文献
AcuteCardiacDisorderorPneumoniaandConcomitant
PresenceofPulmonaryEmbolism
MartinRohacek1*,ZsoltSzucs-Farkas2,CarmenA.Pfortmu¨ller3,HeinzZimmermann1,
AristomenisExadaktylos1
1Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland, 2Department of Diagnostic, Interventional and Pediatric Radiology,
Inselspital,UniversityHospitalBern,Bern,Switzerland,3DepartmentofInternalMedicine,Inselspital,UniversityHospitalBern,Bern,Switzerland
Abstract
Purpose:Todeterminethefrequencyofapparentacutepulmonaryembolism(PE)andofconcomitantdiseaseincomputed
tomographypulmonaryangiography(CTPA);tocomparethefrequencyofPEinpatientswithpneumoniaoracutecardiac
disorder (acute coronary syndrome, tachyarrhythmia, acute left ventricular heart failure or cardiogenic shock), with the
frequencyofPEinpatientswithnoneofthesealternativechestpathologies(comparisongroup).
Methods:RetrospectiveanalysisofallpatientswhoreceivedaCTPAattheemergencydepartment(ED)withinaperiodof
fouryearsand5months.
Results: Of 1275 patients withCTPA, 28 (2.2%) hadPE and concomitant radiologic evidence of another chest disease; 3
more(0.2%)hadPEandanacutecardiacdisorderwithoutradiologicalevidenceofheartfailure.PEwasfoundin11of113
patients(10%)withpneumonia,in5of154patients(3.3%)withanacutecardiacdisorderandin186of1008patients(18%)
in the comparison group. After adjustment for risk factors for thromboembolism and for other relevant patient’s
characteristics,theproportionofCTPAswithevidenceofPEinpatientswithanacutecardiacdisorderorpneumoniawas
significantlylowerthaninthecomparisongroup(OR0.13,95%CI0.05–0.33,p,0.001forpatientswithanacutecardiac
disorder,andOR0.45,95%CI0.23–0.89,p=0.021forpatientswithpneumonia).
Conclusion:ThefrequencyofPEandaconcomitantdiseasethatcanmimicPEwaslow.Thepresenceofanacutecardiac
disorderorpneumoniawasassociatedwithdecreasedoddsofPE.
Citation:RohacekM,Szucs-FarkasZ,Pfortmu¨llerCA,ZimmermannH,ExadaktylosA(2012)AcuteCardiacDisorderorPneumoniaandConcomitantPresenceof
P
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