title: Differences in clinical presentation of pulmonary embolism in older vs younger patients.
abstract: BACKGROUND
  In order to better define the clinical characterization of pulmonary embolism (PE) in the elderly, the clinical and laboratory findings were compared in older (> or = 65 years old) and younger (< 65 years old) patients.
  
  
  RESULTS
  The study group comprised 149 patients (58 older and 91 younger) who received a final diagnosis of PE and were retrospectively evaluated. The severity of PE was assessed by calculating the pulmonary vascular obstruction scores (PVOs) scintigraphically: PVOs > or = 50% was defined as severe disease. Dyspnea was the most frequent symptom in both groups. Chest pain and hemoptysis were less frequent in older patients (48.3% vs 79.1%, p = 0.001; 6.9% vs 20.9%, p = 0.021, respectively) whereas syncope occurred more often in the older group (27.6% vs 9.9%, p = 0.005). PVOs > or = 50% occurred in 55.1% of older and 32.9% of younger patients (odds ratio: 1.67, 95%confidence interval: 1.118-2.507, p = 0.013).
  
  
  CONCLUSIONS
  The clinical presentation of PE can be subtle or atypical in elderly patients and hence they may have more severe disease. Therefore, a high clinical suspicion is required in order to prevent delays in diagnostic work-up and initiation of appropriate treatment.
authors.affiliation: Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey. nkokturk@gazi.edu.tr
authors.forename: Nurdan
authors.initials: N
authors.lastname: Kokturk
authors.forename: I Kivilcim
authors.initials: IK
authors.lastname: Oguzulgen
authors.forename: Nalan
authors.initials: N
authors.lastname: Demir
authors.forename: Koray
authors.initials: K
authors.lastname: Demirel
authors.forename: Numan
authors.initials: N
authors.lastname: Ekim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011877:Radionuclide Imaging; D012189:Retrospective Studies