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Article Dans Une Revue JAMA Cardiology Année : 2021

Prevalence of Pulmonary Embolism Among Patients With COPD Hospitalized With Acutely Worsening Respiratory Symptoms

Jean Pastre
  • Fonction : Auteur
Pierre-Marie Roy
  • Fonction : Auteur
Raphael Le Mao
  • Fonction : Auteur
Frédéric Gagnadoux
  • Fonction : Auteur
Nicolas Paleiron
  • Fonction : Auteur
Jeannot Schmidt
  • Fonction : Auteur
Olivier Sanchez
  • Fonction : Auteur
Mariam Kamara
  • Fonction : Auteur
Clément Hoffmann
  • Fonction : Auteur
Luc Bressollette
  • Fonction : Auteur
Michel Nonent
  • Fonction : Auteur
Cécile Tromeur
  • Fonction : Auteur
Pierre-Yves Salaun
  • Fonction : Auteur
Sophie Barillot
  • Fonction : Auteur
Florence Gatineau
  • Fonction : Auteur
Philippe Girard
  • Fonction : Auteur
Karine Lacut
  • Fonction : Auteur
Catherine Lemarié
  • Fonction : Auteur
Guy Meyer
  • Fonction : Auteur
Christophe Leroyer
  • Fonction : Auteur

Résumé

Background Information is lacking as to the management of patients with superficial venous thrombosis (SVT) whose profile has been excluded from trials, such as patients with active cancer, severe renal impairment, or pregnancy. Objectives To describe the frequency and management of SVT occurring in these situations. Methods We retrospectively analyzed the frequency, management and evolution of all patients with isolated SVT associated with either active cancer, severe renal impairment, or pregnant or postpartum women, diagnosed in 2 university hospital between January 1st, 2015 and December 31st, 2016. Results Of the 594 isolated SVTs individualized from the 7941 reports screened, 149 SVTs (105 in the upper extremity, 44 in the lower extremity) were analyzed: 94 (63%) associated with active cancer, 27 (18%) with severe renal impairment and 30 (20%) pregnant or postpartum women. SVT was treated with anticoagulant in 34 (36%) patients with cancer, 3 (11%) patients with severe renal impairment and 19 (63%) pregnant or postpartum women. At 3-month, 16 patients (10.8%) had a further venous thromboembolic event, 8 (5.4%) major bleeding, and 9 (6.1%) died. Conclusion SVT in patients with active cancer, severe renal impairment and pregnant or postpartum women represents a quarter of isolated SVTs diagnosed. Heterogeneity of treatment patterns mainly affects patients with cancer and severe renal impairment. Poor outcomes, although probably linked to morbidity, call for dedicated research in these specific situations.

Dates et versions

hal-04509035 , version 1 (18-03-2024)

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Citer

Francis Couturaud, Laurent Bertoletti, Jean Pastre, Pierre-Marie Roy, Raphael Le Mao, et al.. Prevalence of Pulmonary Embolism Among Patients With COPD Hospitalized With Acutely Worsening Respiratory Symptoms. JAMA Cardiology, 2021, 325 (1), pp.59. ⟨10.1001/jama.2020.23567⟩. ⟨hal-04509035⟩
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