Characteristics of pulmonary embolism in elderly patients

Introduction: Pulmonary thromboembolism (PE) is an important cause of morbidity and mortality and is greater in elderly, where the increased prevalence of chronic disease make it difficult to suspect and delay the diagnosis. The characteristics of PE in elderly patients have not been extensively studied. The aim of this study is to describe the characteristics of PE in elderly and to identify possible differences between patients older than 80years compared to a lower age range(65-79). Methods: A prospective, descriptive study of case-control was carried out with all patients with confirmed PE included in our RIETE database between year 2002 to 2016. Cases were defined as patients aged 80 years or older and controls as patients aged 65-79years. Statistical analysis was performed with SPSS 17. Results: A total of 445 patients, 189 older than 80 years. Prevalence of AHT, DM and neoplasia was similar in both groups with a higher prevalence of active smokers (16.6% vs. 2.9%) in the younger group and greater comorbidity in the> 80 years. In relation to symptomatology and blood test, the> 80 years present less frequent chest pain (25% vs 40.7%) and swelling in limbs (24% vs 34%); lower HR, higher RR, higher Cr (31% vs 18.8%) and higher D-dimer (6.47 vs 4.53) compared to the 65-79 age group. Mortality from any cause was greater in the > 80years (36% vs 20% OR 2.15) as well as antiplatelet treatment prior to the diagnosis (30% vs 20%). Conclusions: The main differences observed on clinical presentation of PE in elderly were less chest pain, less associated DVT, higher prevalence of antiplatelet therapy and higher mortality, last one perhaps in relation to diagnostic-therapeutic delay and worse basal conditions.