Factors influencing mortality in ICU patients with suspected massive pulmonary embolism

In this study, risk factors of mortality of patients diagnosed with massive pulmonary embolism (PE) who were followed in ICU and complications of its9 were studied. 60 patients who were followed in the ICU pre-diagnosed with massive PE were included in this study, 31 of them were women (51.7%) and the mean age was 67.1 years. 57% of the patients were admitted from emergency department, and 28% of them from external center. The most common co-morbidities were heart failure, malignancy, and postoperative situation. The diagnosis of PE was made with dynamic CT in 57 patients (95%). 32 patients were diagnosed with massive PE and 28 patients were diagnosed with submassive PE. Bedside ECHO was made in all patients and signs of acute cor pulmonale (RAD, RVD) were detected in 37 patients. 32 of 37 patients who had acute cor-pulmonala were given to thrombolytic therapy (rtPA). There were signs of respiratory failure in 31 patients, 13 of them non-invasive, and 16 underwent invasive ventilation. The mortality of patients diagnosed with massive PE was 25.0%, and that was 32.1% in patients with submassive PE. The mortality rate of patients with malignant disease and PE was 43%, and that was 51.6% in patients with respiratory failure. Various complications occurred in 11 patients, and the mortality rate in these patients was 72.7%. Independent variables that were affecting mortality in the logistic regression analysis were tachycardia, low GCS score, elevated CRP levels and the presence of respiratory failure. If patients who were diagnosed with massive PE and who had tachycardia, low level of consciousness, and respiratory failure, thrombolytic therapy must be applied due to higher mortality risk.