title: Time between first symptoms and diagnosis in patients with acute pulmonary embolism: are patients with recurrent episodes diagnosed earlier?
abstract: BACKGROUND
  Early diagnosis can be life-saving in acute pulmonary embolism (PE). It is unknown, whether patients with recurrent PE are diagnosed earlier than those with their first episode.
  
  
  METHODS
  Admission data of patients with symptomatic acute PE were reviewed over a period of 47 months. Delay in diagnosis, demographics, body mass index, comorbidity, mortality, risk factors for venous thromboembolism and socio-economic status were recorded.
  
  
  RESULTS
  56 out of 248 patients had recurrent PE, 192 patients were hospitalized because of their first episode. Delay in diagnosis after symptom onset was significantly greater in patients with recurrent than in patients with their first PE (3.4 ± 2.3 vs. 2.2 ± 1.7 days, p = 0.006). Recurrent PE was significantly more often unprovoked (p < 0.001); by contrast, preceding trauma or surgery were significantly (p = 0.007) more frequent in first PE.
  
  
  CONCLUSIONS
  Missing predisposing factors in unprovoked PE might explain the greater delay in diagnosis in recurrent PE. Physicians should focus more on informing patients about the possibility of PE recurrence and associated symptoms and thereby enable earlier diagnosis in recurrent PE.
authors.affiliation: Department of Cardiology, Pneumology, Intensive Care and Endocrinology, Klinikum Augsburg, Academic Teaching Hospital of the Ludwig-Maximilians-University Munich, Stenglinstrasse 2, 86156, Augsburg, Germany. thomas.berghaus@klinikum-augsburg.de
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Berghaus
authors.forename: W
authors.initials: W
authors.lastname: von Scheidt
authors.forename: M
authors.initials: M
authors.lastname: Schwaiblmair
mesh_terms: D000208:Acute Disease; D000368:Aged; D042241:Early Diagnosis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000401:mortality*; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors
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