Punukollu Himabindu, Khan Ijaz A, Punukollu Gopikrishna, Gowda Ramesh M, Mendoza Concha, Sacchi Terrence J
Department of Medicine, Long Island College Hospital, Brooklyn, NY, USA.
Int J Cardiol. 2005 Mar 18;99(2):213-6. doi: 10.1016/j.ijcard.2004.01.011.
To evaluate the clinical characteristics and outcome of acute pulmonary embolism in elderly in comparison to the younger patients.
Study population consisted of 136 patients with a confirmed diagnosis of acute pulmonary embolism. Clinical characteristics and thromboembolic risk factors were analyzed between the elderly (> or =65 years of age) and the younger (<65 years of age) patients. In-hospital mortality was used as a measure of outcome.
Elderly group consisted of 70 patients (age 76.4+/-8.3 years, range 65-96 years; females 58%) and younger group of 66 patients (age 48.5+/-12 years, range 18-64 years, females 59%). Syncope was more frequent in elderly group (19% vs. 6%, P=0.03) but the symptoms of shortness of breath and pleuritic chest pain were not significantly different between groups. Malignancy was the most common risk factor for thrombo-embolism, but immobilization predominated among patients in elderly group (21% vs. 6%, P=0.01). Tachycardia was common in younger patients compared to the elderly. Ventilation-perfusion scan was used more commonly in younger patients (76% vs. 57%, P=0.02), whereas, helical computed-tomography scan was used equally in both groups. Most of the patients had lower extremity duplex study (97% in each group). Inferior vena cava filter placement was common and thrombolytic therapy rare among elderly patients. Patients in elderly group had higher in-hospital mortality (17% vs. 5%, P=0.02).
Syncope is a more frequent presenting symptom and immobilization a common risk factor in elderly patients with acute pulmonary embolism. In addition, they have higher in-hospital mortality.
比较老年急性肺栓塞患者与年轻患者的临床特征及预后。
研究对象为136例确诊为急性肺栓塞的患者。分析老年（≥65岁）和年轻（<65岁）患者的临床特征及血栓栓塞危险因素。以住院死亡率作为预后指标。
老年组70例（年龄76.4±8.3岁，范围65 - 96岁；女性占58%），年轻组66例（年龄48.5±12岁，范围18 - 64岁，女性占59%）。晕厥在老年组更常见（19%对6%，P = 0.03），但两组间气短和胸膜炎性胸痛症状无显著差异。恶性肿瘤是血栓栓塞最常见的危险因素，但制动在老年组患者中占主导（21%对6%，P = 0.01）。与老年患者相比，心动过速在年轻患者中更常见。通气 - 灌注扫描在年轻患者中使用更普遍（76%对57%，P = 0.02），而螺旋计算机断层扫描在两组中使用相当。大多数患者进行了下肢双功超声检查（每组97%）。老年患者中，下腔静脉滤器置入常见，溶栓治疗少见。老年组患者住院死亡率更高（17%对5%，P = 0.02）。
晕厥是老年急性肺栓塞患者更常见的症状，制动是常见的危险因素。此外，他们的住院死亡率更高。
