XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
  Asthma
  COPD
  Cystic Fibrosis
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
 
 India
Search

Last Updated: Nov 18, 2006 - 12:32:53 PM

Respiratory Medicine Channel
subscribe to Respiratory Medicine newsletter

Latest Research : Respiratory Medicine

   DISCUSS   |   EMAIL   |   PRINT
New Model To Help Physicians Identify Patients With Pulmonary Embolism
Jan 25, 2006 - 12:27:00 AM, Reviewed by: Dr. Sanjukta Acharya

"Outpatient treatment for nonmassive PE is not widely accepted because no explicit clinical criteria exist to accurately identify patients with PE who are at low risk of adverse outcomes,"

 
Looking at 10 easily obtained risk factors, including age, blood pressure and medical history, could help physicians identify patients with pulmonary embolism who are at low risk of death in the short term and therefore are candidates for outpatient treatment, according to a new study in the January 23 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

Pulmonary embolism (PE) generally occurs when a blood clot that develops in the veins of the leg or pelvis becomes dislodged and results in sudden blockage of an artery in the lung. It is a major health problem in the United States, causing more than 100,000 hospitalizations in 2002, according to background information in the article. The condition can be fatal, but evidence suggests that nonmassive PE, which is not accompanied by respiratory failure or other serious complications, could effectively and safely be treated on an outpatient basis, the authors write.

Previous studies have shown that outpatient treatment for PE also could be economically beneficial-the authors estimate that if 20 percent of people with PE were treated as outpatients, up to $91 million per year could be saved in the United States alone. However, "outpatient treatment for nonmassive PE is not widely accepted because no explicit clinical criteria exist to accurately identify patients with PE who are at low risk of adverse outcomes," they write. "Therefore, we sought to develop an objective and easily applied clinical prediction rule to identify patients with PE at low risk of short-term mortality and other adverse medical outcomes who are candidates for outpatient treatment."

Drahomir Aujesky, M.D., M.Sc., University of Lausanne, Switzerland, and colleagues developed this prediction rule or model by evaluating 15,531 admitted patients who received a discharge diagnosis of PE from 186 Pennsylvania hospitals. By concentrating on 10,354 patients, they identified 10 risk factors that indicated a greater risk of short-term death (within 30 days), including an age of 70 years or older; a history of cancer, heart failure, chronic lung disease or chronic kidney disease; cardiovascular disease; altered mental status; a high pulse rate; low systolic blood pressure; and reduced oxygen saturation in arterial blood. Patients without any of these factors are considered low-risk and eligible for outpatient treatment.

The researchers then tested their model on the remaining 5,177 participants in the original study group and by using data from a previous study of 221 Swiss patients with PE. Low numbers of patients in these two groups-1.5 percent and none, respectively-who were low-risk according to the model died within 30 days, and less than 1 percent developed non-fatal complications. "This simple prediction rule accurately identifies patients with pulmonary embolism who are at low risk of short-term mortality and other adverse medical outcomes," the authors write. "Prospective validation of this rule is important before its implementation as a decision aid for outpatient treatment."

Although previous studies have linked certain indicators with prognosis for patients with PE, none have been used to group patients by risk, writes Lisa K. Moores, M.D., Walter Reed Army Medical Center, Washington, D.C., in an accompanying editorial. "The important question may not be who has PE but who is likely to have a recurrent fatal PE?" she writes.

"The study by Aujesky and colleagues is exciting because it is the first to combine several factors into a score that can be used to determine the appropriate treatment setting," Dr. Moores writes. "Perhaps more importantly, the risk score can be calculated quickly and reliably with clinical data easily obtained in the initial history review and physical examination."
 

- January 23 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
 

Arch Intern Med. 2006;166:169-175

 
Subscribe to Respiratory Medicine Newsletter
E-mail Address:

 

This study was funded by a grant from the National Heart, Lung, and Blood Institute, Bethesda, Md.; by the Swiss Foundation in Medicine and Biology, Bern, and the Swiss Medical Association, Bern; and by a Career Development Award from the National Institute of Allergy and Infectious Diseases, Bethesda.

Related Respiratory Medicine News

Acute lung injury is prevented by FoxM1 protein
Six-minute walk test predicts mortality rates in patients with pulmonary fibrosis
A dog in home may worsen asthma in children
Cystic fibrosis-related diabetes is due to functional abnormalities in beta cells
COPD patients using beta-agonist inhalers are at risk
Beta-agonists linked with increased number of respiratory deaths -study shows
Beta-agonists more than double death rate in COPD patients
No evidence for inhaled corticosteroids efficacy in cystic fibrosis
Lung function test underused in patients with COPD
Wrinkles clue to risk of progressive lung disease (COPD)


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us