title: Acute pulmonary embolism in elderly: clinical characteristics and outcome.
abstract: OBJECTIVE
  To evaluate the clinical characteristics and outcome of acute pulmonary embolism in elderly in comparison to the younger patients.
  
  
  METHODS
  Study population consisted of 136 patients with a confirmed diagnosis of acute pulmonary embolism. Clinical characteristics and thromboembolic risk factors were analyzed between the elderly (> or =65 years of age) and the younger (<65 years of age) patients. In-hospital mortality was used as a measure of outcome.
  
  
  RESULTS
  Elderly group consisted of 70 patients (age 76.4+/-8.3 years, range 65-96 years; females 58%) and younger group of 66 patients (age 48.5+/-12 years, range 18-64 years, females 59%). Syncope was more frequent in elderly group (19% vs. 6%, P=0.03) but the symptoms of shortness of breath and pleuritic chest pain were not significantly different between groups. Malignancy was the most common risk factor for thrombo-embolism, but immobilization predominated among patients in elderly group (21% vs. 6%, P=0.01). Tachycardia was common in younger patients compared to the elderly. Ventilation-perfusion scan was used more commonly in younger patients (76% vs. 57%, P=0.02), whereas, helical computed-tomography scan was used equally in both groups. Most of the patients had lower extremity duplex study (97% in each group). Inferior vena cava filter placement was common and thrombolytic therapy rare among elderly patients. Patients in elderly group had higher in-hospital mortality (17% vs. 5%, P=0.02).
  
  
  CONCLUSIONS
  Syncope is a more frequent presenting symptom and immobilization a common risk factor in elderly patients with acute pulmonary embolism. In addition, they have higher in-hospital mortality.
authors.affiliation: Department of Medicine, Long Island College Hospital, Brooklyn, NY, USA.
authors.forename: Himabindu
authors.initials: H
authors.lastname: Punukollu
authors.forename: Ijaz A
authors.initials: IA
authors.lastname: Khan
authors.forename: Gopikrishna
authors.initials: G
authors.lastname: Punukollu
authors.forename: Ramesh M
authors.initials: RM
authors.lastname: Gowda
authors.forename: Concha
authors.initials: C
authors.lastname: Mendoza
authors.forename: Terrence J
authors.initials: TJ
authors.lastname: Sacchi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D036542:Tomography, Spiral Computed; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging