Tisserand G, Gil H, Méaux-Ruault N, Magy-Bertrand N
Service de médecine interne, CHU Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France; Université de Franche-Comté, 25000 Besançon, France.
Service de médecine interne, CHU Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France.
Rev Med Interne. 2014 Jun;35(6):353-6. doi: 10.1016/j.revmed.2013.07.004. Epub 2013 Aug 20.
To date only a few studies regarding pulmonary embolism (PE) in elderly have been published. The aim of this study was to determine the clinical features of PE in elderly patients (≥ 75 years).
All patients hospitalized for PE in our internal medicine department from January 2005 to December 2010 were included in the study. The aim was to compare the features of PE in elderly patients (≥ 75 years) to those of patients younger than 75 years. The following data were recorded: past medical history, risk factors for venous thrombo-embolism (VTE), clinical features, and PE etiologies.
The population was composed of 64 patients (women 56%) with a median age of 82 years (IQR: 13.5). There was no statistical difference for risk factors of VTE. Syncope was more frequent in elderly patients (33% versus 7%, P=0.04) whereas thoracic pain predominated in younger patients (36,5% versus 7%, P=0.005). Chronic obstructive pulmonary disease was more frequent in the past medical history of elderly patients. The diagnostic of PE was less suspected in elderly patients (47% versus 72%, P=0.035). The etiologies were similar between the two groups.
Our study highlights the frequency of syncope as the presenting feature of PE in elderly, whereas thoracic pain is uncommon. We confirmed the difficulty to diagnose PE in elderly population.
迄今为止，仅有少数关于老年患者肺栓塞（PE）的研究发表。本研究的目的是确定老年患者（≥75岁）PE的临床特征。
纳入2005年1月至2010年12月在我院内科住院的所有PE患者。目的是比较老年患者（≥75岁）与75岁以下患者的PE特征。记录以下数据：既往病史、静脉血栓栓塞（VTE）的危险因素、临床特征和PE病因。
研究人群包括64例患者（女性占56%），中位年龄82岁（四分位间距：13.5）。VTE的危险因素无统计学差异。老年患者晕厥更为常见（33%对7%，P=0.04），而年轻患者以胸痛为主（36.5%对7%，P=0.005）。老年患者既往病史中慢性阻塞性肺疾病更为常见。老年患者中PE的诊断较少被怀疑（47%对72%，P=0.035）。两组病因相似。
我们的研究强调了晕厥作为老年PE患者主要表现的频率，而胸痛并不常见。我们证实了老年人群中诊断PE的困难。
