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ASSESMENT OF PULMONARY THROMBOEMBOLISM PATIENTS DIAGNOSED IN OUR CLINIC A. Şimşek , G.Ö. Türkkan, K. Melek F.Ö.Eyüboğlu. University of Baskent, Department of Chest Disease. INTRODUCTION.
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ASSESMENT OF PULMONARY THROMBOEMBOLISM PATIENTS DIAGNOSED IN OUR CLINICA. Şimşek, G.Ö. Türkkan, K. Melek F.Ö.Eyüboğlu University of Baskent, Department of ChestDisease
INTRODUCTION • Venous thromboemboli (VTE) is the third most common cardiovascular disease after the ischemic heart disease and stroke. • The risk of PTE increases with advanced age • It was seen in male and female with same ratio
PULMONARY THROMBOEMBOLISM (PTE) • Annual incidence : 0.23-1.83/1000 • Mortality rate : • without treatment: 30 % • with treatment: 14.7 • Cause can not be identified at 19-47% • Recurrance: • First year: 7-8 % • After 8-10 years: 30 %
Immobilization Malignancy Trauma Advanced age Cardiopulmonary dis. Surgery Previous VTE Obesity Cerebrovasculary disease OC usage RISK FACTORS FOR PTE ACQUIRED RISK FACTORS
Antiphospholipid Antibody Synd Prothrombin 20210 A mut. Increased Lipoprotein A Methylentetrahydrofolate reductase mutation(?) RISK FACTORS GENETIC RISK FACTORS • Antithrombin III deff • Protein C defficiency • Protein S defficiency • FV Leiden mutation • Hyperhomocysteinemie
AIM The aim of this study was to define risk factors for PTE, clinical characteristics, demographic data of subjects, diagnostic procedures, and treatment responses
MATERIAL AND METHOD We retrospectively analysed data from 164 patients admitted to our clinic with PTE in our hospital between 2000 to 2005
MATERIAL AND METHOD • Sex • Age • Risk factors • Symptoms • Thorax CT • Lower extremities venous doppler US
MATERIAL AND METHOD • Severity of PTE • Drugs used for treatment • Mortality rate • Recurrance rate
RESULTS • Female ratio : 55.5 % • Male ratio : 44.5 % • Mean Age : - Female : 69.3 ± 13.6 - Male : 62.7 ± 18.3 - General : 66.3 ± 16.1
RESULTS • Risk factors for PTE were absent in 25.6% of patients (idiopathic)
PRESENCE OF LOWER EXTREMİTES VENOUS THROMBUS The ratio of cardiac thrombus was 5.5 %
Most frequently seen risk factors • Immobilization • Surgery • Most frequently seen surgery Sugery to lower extremities
In this study; • Lung and rectum cancer rates were lower than other studies • Liver cancer rate was higher than other studies • Pancreas cancer was not seen anymore
According to our study, all malignancies can cause PTE • Our hospital is a solid organ transplantation center, for that reason liver cancer rate might be found high
Lower ext. thrombus rate • Cardiac thrombus rate Similar with literature Recurrance rate was higher than literature
The reason of high recurrance rate of PTE in our study may be associated with long term (5 year) follow up • Long term follow up is more informative than 6-12 months follow up in determining recurrance rate
Mortality rate was lower than literature • Early diagnosis • Early treatment • Long term follow up Effective in determining low mortality rates
RESULTS • In order to determine correct recurrance rates, 5 year follow up is necessary • Long term and near follow up may reduce mortality • In presence of malignancy, VTE should be kept in mind as a complication • Because of high rate of idiopathic PTE, hereditary thrombophylic factors should be searched in all patients