Characteristics, incidence and outcome of patients admitted to intensive care because of pulmonary embolism. Issue 2 (11th September 2016)

• Record Type: Journal Article
• Authors: Winterton, Dario; Bailey, Michael; Pilcher, David; Landoni, Giovanni; Bellomo, Rinaldo
• Is Part Of: Respirology. Volume 22:Issue 2(2017)
• Page Start: 329
• Page End: 337
• Publication Date: 2016-09-11
• Subjects: epidemiology -- intensive care unit -- mechanical ventilation -- mortality -- pulmonary embolism; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.12881
• Languages: English
• ISSNs: 1323-7799

Abstract

ABSTRACT: Background and objective: Despite the clinical significance of major pulmonary embolism (PE), little is known about patients with a presentation severe enough to lead to intensive care unit (ICU) admission and nothing is known about PE requiring mechanical ventilation (MV). We aimed to examine the characteristics, incidence and outcome of patients with PE as their reason for ICU admission. Methods: We performed a retrospective, cross‐sectional study of patients admitted to Australia's and New Zealand's ICUs because of PE from 2005 to 2013. We compared survivors with non‐survivors and mechanically ventilated with non‐ventilated patients. We analysed variations in incidence and mortality over time. Results: We studied 2797 patients. PE accounted for 0.3% of all ICU admissions and had a population incidence of 11 cases/million people/year, which increased significantly during the study period ( P < 0.0001). Co‐morbidities were common (24.1%) and the emergency department was the most common admission source (49.1%). However, patients who died were more commonly admitted from the wards ( P < 0.0001). Overall mortality was 14.1% but reached 41.0% in patients requiring MV ( P < 0.0001). Illness severity‐adjusted mortality rate did not change during the study period. Conclusion: The incidence of PE requiring admission to ICU has increased over time; its mortality rate remains high, especially in mechanically ventilated patients, and its prognosis has not improved over time. Our findings imply the need for focused research in this high‐risk patient group. Abstract : Little is known about pulmonary embolism severe enough to require intensive care unit admission and/or mechanical ventilation. For the first time, using a bi‐national multicentre database, we assess the epidemiology of this condition, provide a description of this population and describe changes in outcome over time. See Editorial, page 213