Clinical presentation and results of thrombolytic therapy in older patients with massive pulmonary embolism: a comparison with non-elderly patients.
OBJECTIVE
To assess the clinical presentation and effectiveness of thrombolytic therapy in older patients suffering from massive pulmonary embolism.


METHODS
Analysis of a previously reported study of patients with massive pulmonary embolism using a dichotomous classification of age.


METHODS
A medical intensive care unit in one hospital center.


METHODS
All subjects had massive pulmonary embolism as evidenced by scintigraphic and/or angiographic assessment. The 54 patients included in this study were divided into two groups according to age: 28 patients were less than 75 years old and 26 patients were 75 years old or older.


METHODS
All patients received a bolus regimen of single-chain recombinant tissue-type plasminogen and were subsequently treated by heparin and warfarin.


METHODS
Clinical symptoms at admission, resolution of scintigraphic vascular obstruction, death rate, hemorrhagic complications, recurrent pulmonary embolism, and long-term follow-up were compared between both groups.


RESULTS
Clinical symptoms at admission were similar in both groups. The mean absolute improvement in the lung scan perfusion defect, the rate of major bleeding, and the long-term evolution were not statistically different between older and younger patients.


CONCLUSIONS
Clinical symptoms, including hemodynamic condition, did not differ between elderly and nonelderly patients suffering from massive pulmonary embolism. Old age should not preclude thrombolytic therapy in massive pulmonary embolism, provided there is no other contraindication for thrombolytic treatment.
Gisselbrecht
M
M
Service de Pneumologie et Réanimation, Hôpital Laennec, Paris, France.
Diehl
J L
JL
Meyer
G
G
Collignon
M A
MA
Sors
H
H
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator