Abstract

Objective: The mortality and incidence of pulmonary thromboembolism (PE) increases with advancing age. Despite the diagnostic developments in recent years, the disease is still difficult to diagnose especially in elderly people. The aim of this study was to compare the clinical presentation of PE in young and elderly patients, examine the parameters determining the risk and prognosis and finally contribute to a decrease in mortality.

Material and Method: This study comprised 141 patients diagnosed as PE. The patients were divided into two groups, <65 years (young group) and ≥65 years (elderly group). The clinical, laboratory and instrumental findings of the patients were evaluated retrospectively.

Results: The most common risk factors in both groups were immobility and recent surgery. Chest pain and hemoptysis were less frequent in the elderly group, while tachycardia was more common in this group of patients (p<0.001, p=0.013 and p=0.047, respectively). Patients with massive PE had a higher value of D-Dimer and electrocardiography (ECG) score compared to patients with non-massive PE (p=0.01, p<0.001, respectively). D-Dimer and cardiac troponin levels and ECG score were higher in patients who died in the hospital when compared to the individuals who survived (p=0.02, p=0.018, p=0.008, respectively).

Conclusion: Since PE may present with atypical clinical findings in the elderly, a high level of clinical suspicion is required for the diagnosis. Use of the parameters which can determine the severity, risk and prognosis of the disease at an early stage may enable the initiation of appropriate treatment in the early phases of the disease, thereby decreasing the mortality. (Tur Toraks Der 2010; 11: 160-6)