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  • Title: Clinical implications of right ventricular dysfunction in patients with acute symptomatic pulmonary embolism: short- and long-term clinical outcomes.
    Author: Yoo JW, Hong SB, Lim CM, Koh Y.
    Journal: J Crit Care; 2012 Jun; 27(3):325.e1-6. PubMed ID: 22033062.
    Abstract:
    PURPOSE: Right ventricular dysfunction (RVD) has been found to have a negative impact on the short-term prognosis of patients with pulmonary embolism (PE). However, the long-term prognosis of such patients has not been well defined. We evaluated the effect of RVD on short- and long-term mortality in Korean patients with PE. MATERIALS AND METHODS: We retrospectively assessed 180 patients with PE who underwent transthoracic echocardiography to evaluate RVD between January 2004 and December 2008. Patients were categorized as hemodynamically stable without RVD (stable without RVD, n = 70), hemodynamically stable with RVD (stable with RVD, n = 74), or hemodynamically unstable with RVD (unstable with RVD, n = 36). The clinical courses of all patients were followed up in-hospital and after discharge. RESULTS: Nineteen patients (10.5%) died during hospitalization, with the unstable with RVD group showing the highest rate of in-hospital mortality (27.8%, P < .05) and PE-related deaths (16.7%, P < .05), but no difference in these parameters was noted between the other 2 groups. Multivariate analysis showed that older age and hemodynamic instability were independent risk factors for poor in-hospital outcomes. Eleven patients died after discharge. Multivariate analysis showed that older age, immobilization, and malignancy were independent predictors of long-term mortality. CONCLUSION: Right ventricular dysfunction without hemodynamic instability was not associated with short- or long-term mortality of patients with PE.
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