Lisette van Dam

Chapter 10 160 Primary outcome The prevalence of symptoms at presentation and adverse short-term outcome with associated mean PDS are presented in Table 2 . Of the 100 patients, dyspnea was present in 84 (84%), pleural chest pain in 55 (55%), non-pleural chest pain in 25 (25%), and hemoptysis in 6 patients (6.0%). A total of 60 patients (60%) were admitted to the hospital, of whom 7 patients (7.3%) were admitted to the ICU. Twenty-five patients (26%) were treated with oxygen > 24 hours, 6 patients (6.3%) received intravenous pain medication > 24 hours, 4 patients (4.2%) received reperfusion therapy, and 3 patients (3.1%) needed vasopressor/inotropic therapy. We did not find a relevant correlation between PDS and clinical presentation ( Table 2 ). The PDS was associated with reperfusion therapy (16% higher PDS, 95%CI 3.5-28%) and PE-related mortality (22% higher PDS, 95%CI 4.9-39%; Table 2) . The PDS was not associated with the need for oxygen therapy, pain medication or vasopressor/inotropic therapy nor with ICU admission. Table 2. Perfusion defect score (PDS) in 100 acute pulmonary embolism (PE) patients and correlation to presenting symptoms and short-term adverse outcome Prevalence (%) Mean (SD) PDS in % in patients with: Mean (SD) PDS in % in patients without: Difference (95% CI) Symptoms at presentation (n = 100) and 7-day outcome (n = 96) Pleural chest pain† 55 (55) 28 (14) 27 (12) 1.5 (-3.7 to 6.7) Non-pleural chest pain† 25 (25) 32 (12) 26 (13) 5.5 (-0.41 to 11) Dyspnea 84 (84) 28 (13) 25 (13) 3.4 (-3.7 to 11) Hemoptysis 6 (6.0) 27 (14) 27 (13) -0.74 (-12 to 10) Hospital admission 60 (60) 28 (14) 27 (11) 0.92 (-4.4 to 6.2) ICU admission 7 (7.3) 32 (19) 26 (12) 5.7 (-3.9 to 15) Oxygen therapy > 24 hours 25 (26) 28 (15) 26 (12) 1.4 (-4.3 to 7.2) IV pain medication > 24 hours 6 (6.3) 23 (12) 27 (12) -4.6 (-15 to 5.7) Reperfusion therapy 4 (4.2) 42 (14) 26 (12) 16 (3.5 to 28)* Need for vasopressor therapy 3 (3.1) 34 (32) 27 (12) 7.6 (-6.8 to 22) PE related death 2 (2.1) 49 (19) 27 (12) 22 (4.9 to 39)* † Patients could have either pleural chest pain or non-pleural chest pain, or both at the same time.*symptoms/outcome correlated to PDS on CTPP ICU, intensive care unit