Abstract 332: Characteristics of Patients with Submassive Pulmonary Embolism with Early Re-hospitalization After tPA Administration

Abstract

Background: Evidence for clinical predictors of early re-hospitalization after tissue plasminogen activator (tPA) therapy in patients with submassive pulmonary embolism (SMPE) is currently lacking. We sought to explore the characteristics of these patients in a retrospective cohort study at our hospital Methods: Clinical, biochemical, hemodynamic, echocardiographic characteristics and clinical course of consecutive patients with SMPE [as defined by Acute PE without systemic hypotension (systolic blood pressure >90 mm Hg) but with either Right Ventricular strain/dysfunction demonstrated on echocardiography obtained within 24 hours of presentation or myocardial necrosis as evidenced by elevated cardiac troponins and/or elevated brain natriuretic peptide levels)] were studied in a retrospective cohort study. Unplanned all cause re-hospitalizations after the index hospitalization for SMPE were captured Results: A total of 145 (in past 5 years) patients with pulmonary embolism diagnosed with spiral CT angiography or ventilation perfusion scan were screened for patients with SMPE. 17 patients with SMPE were identified in whom tPA was administered. No patient had major bleeding, one patient suffered gross hematuria during the tPA administration. After a mean 2.1 years of follow up 5 (29%) patients suffered unplanned all cause re-hospitalizations among which 4 were within one year from the index hospitalization for SMPE. Baseline characteristics are shown in table 1. No patients had recurrent PE after the index hospitalization Conclusion: A significant proportion of patients were re-hospitalized within one year after tPA administration in patients with SMPE. Further studies in larger cohorts are needed to identify independent clinical predictors of re-hospitalization in patients with submassive pulmonary embolism