Prognostic stratification of acute pulmonary embolism: focus on clinical aspects, imaging, and biomarkers.
Pulmonary embolism (PE) represents a common disease in emergency medicine and guidelines for diagnosis and treatment have had wide diffusion. However, PE morbidity and mortality remain high, especially when associated to hemodynamic instability or right ventricular dysfunction. Prognostic stratification to identify high risk patients needing to receive more aggressive pharmacological and closer monitoring is of utmost importance. Modern guidelines for management of acute PE are based on risk stratification using either clinical, radiological, or laboratory findings. This article reviews the modern treatment of acute PE, which is customized upon patient prognosis. Accordingly the current risk stratification tools described in the literature such as clinical scores, echocardiography, helical computer tomography, and biomarkers will be reviewed.
Masotti
Luca
L
UO Medicina Interna, Ospedale di Cecina, Via Montanara, Località Ladronaia, 57023 Cecina (Li), Italy. luca.masotti@tin.it
Righini
Marc
M
Vuilleumier
Nicolas
N
Antonelli
Fabio
F
Landini
Giancarlo
G
Cappelli
Roberto
R
Ray
Patrick
P
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood*; D003952:Diagnostic Imaging / Q000379:methods; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy; D036542:Tomography, Spiral Computed
D015415:Biomarkers