P274 GUESS WHO‘S COMING TO REANIMATION? ANALYSIS OF THE ELDERLY PATIENT WITH EMBOLISM IN NEED OF HOSPITALIZATION IN INTENSIVE CARE: REAL LIFE IN THE EMERGENCY ROOM

Abstract

Abstract Premise Pulmonary embolism is a disease still characterized by high mortality and which may require hospitalization in intensive care. Purpose Evaluate which parameters, in the real life of an Emergency Department, correlate with the need and the duration of hospitalization in intensive care. Methods Single–center retrospective observational study, on all geriatric patients (> 75) who refer to our ED, where they were diagnosed with acute PE. Enrollment began in 2015 and ended in 2019. We collected data from medical history, physical examination, laboratory tests, imaging, outcomes. Results We enrolled 247 patients, with a mean age of 83 years and female prevalence (F = 63%). Of these 12 (14 %) required hospitalization in intensive care from the emergency room. Regarding the need for hospitalization in resuscitation, age and vital parameters (arterial pressure, respiratory rate, heart rate), as well as derived shock indices are not correlated (p > 0.05). Only the systolic blood pressure values and it show a trend which however does not reach statistical significance (p = 0.06). Among the blood gas analysis parameters, only low pCO2 has a slight correlation (p < 0.05). The D–Dimer (p < 0.01) and creatinine values (p < 0.05) show correlation between the blood chemistry tests. Regarding the length of stay in resuscitation, age and vital parameters (blood pressure, respiratory rate, heart rate), as well as derived shock indices, do not show any correlation (rho∼0; p > 0.05). A weak correlation is instead present with high values of D–Dimer (rho∼0.25; p < 0.005) and creatinine (rho∼0.33; p < 0.0005). The presence of massive pulmonary embolism shows no correlation (p > 0.5). The presence of organ damage, on the other hand, correlates in a statistically significant manner (p < 0.0005). Excellent correlation is shown by the sPESI index (p < 0.0001). Discrete correlation showed the alteration in pH (rho∼0.61; p < 0.0001). Correlation for the blood gas analysis parameters taken into consideration (pH; pO2; pCO2; lactates). Conclusions The study suggests a reduced significance of vital parameters and indices derived from them for the need and duration of hospitalization in resuscitation. Presence of organ damage, low pCO2 values and high D–Dimer and creatinine values are associated with both the need for hospitalization in resuscitation and duration.