Characteristics, incidence and outcome of patients admitted to intensive care because of pulmonary embolism

Dario Winterton, Michael Bailey, David Pilcher, Giovanni Landoni, Rinaldo Bellomo

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)329–337
Number of pages9
JournalRespirology
Volume22
Issue number2
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Epidemiology
  • Intensive care unit
  • Mechanical ventilation
  • Mortality
  • Pulmonary embolism

Cite this

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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.",
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Characteristics, incidence and outcome of patients admitted to intensive care because of pulmonary embolism. / Winterton, Dario; Bailey, Michael; Pilcher, David; Landoni, Giovanni; Bellomo, Rinaldo.

In: Respirology, Vol. 22, No. 2, 02.2017, p. 329–337.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Characteristics, incidence and outcome of patients admitted to intensive care because of pulmonary embolism

AU - Winterton, Dario

AU - Bailey, Michael

AU - Pilcher, David

AU - Landoni, Giovanni

AU - Bellomo, Rinaldo

PY - 2017/2

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N2 - 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.

AB - 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.

KW - Epidemiology

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