Pol Arch Intern Med. 2021 Dec 22;131(12). doi: 10.20452/pamw.16134. Epub 2021 Nov 15.
Currently, venous thromboembolism, including deep vein thrombosis and acute pulmonary embolism (PE), is globally the third most frequent acute cardiovascular syndrome with rising incidence rates. The clinical presentation of PE is heterogenous: from incidental findings on imaging studies to sudden cardiac death. Hemodynamic instability identifies patients at high risk of early mortality. In hemodynamically stable patients, further stratification into intermediate- and low-risk categories is advised, preferably using a combined risk assessment strategy based on clinical parameters, laboratory findings, and imaging markers. Treatment should be tailored to the risk of early death, with more aggressive treatments reserved for patients at higher risk of complications. This review offers an update on the current strategies for assessing PE severity and the risk of early death and discusses developments in predicting mortality risk in patients with PE.
目前，静脉血栓栓塞症（包括深静脉血栓形成和急性肺栓塞）是全球第三大常见的急性心血管综合征，发病率呈上升趋势。PE 的临床表现具有异质性：从影像学检查中的偶发发现到心脏性猝死。血流动力学不稳定可识别出具有早期死亡高风险的患者。对于血流动力学稳定的患者，建议进一步进行中危和低危分层，最好使用基于临床参数、实验室发现和影像学标志物的综合风险评估策略。治疗应根据早期死亡风险进行调整，对于有更高并发症风险的患者，应采用更积极的治疗方法。本综述介绍了评估 PE 严重程度和早期死亡风险的当前策略，并讨论了预测 PE 患者死亡风险的新进展。
