老年人肺栓塞的临床表现与诊断。

Pulmonary embolism: clinical presentation and diagnosis in the oldest old.

机构信息

South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Department of Aged Care, Rehabilitation and Psychogeriatrics, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia.

出版信息

Intern Med J. 2020 May;50(5):627-631. doi: 10.1111/imj.14824.

DOI:10.1111/imj.14824

PMID:32431035

Abstract

The incidence of pulmonary embolism (PE) in the oldest old (persons aged ≥85) is increasing, but there are limited data on its clinical features and diagnosis. We performed a retrospective cohort study of 302 consecutive patients with confirmed PE and compared the oldest old to the young (aged <65) and the younger old (aged 65-84). The most common symptoms in the oldest old were dyspnoea (74.3%) and tachypnoea (71.4%), but the prevalence of chest pain decreased with advancing age. Delayed diagnosis was most common in the oldest old and was associated with increasing age, absence of dyspnoea, presence of cardiorespiratory disease and a higher Charlson Comorbidity index. Better age-specific diagnostic pathways are required in this population.

摘要

高龄（≥85 岁）人群中的肺栓塞（PE）发病率正在增加，但关于其临床特征和诊断的数据有限。我们对 302 例确诊的 PE 连续患者进行了回顾性队列研究，并将高龄组与年轻组（<65 岁）和较年轻组（65-84 岁）进行了比较。高龄组最常见的症状是呼吸困难（74.3%）和呼吸急促（71.4%），但胸痛的发生率随年龄增长而降低。高龄组最常见的是延迟诊断，且与年龄增长、无呼吸困难、存在心肺疾病和较高的 Charlson 合并症指数有关。在这一人群中需要制定更具年龄特异性的诊断途径。