title: Clinical features and short term outcomes of patients with acute pulmonary embolism. The Italian Pulmonary Embolism Registry (IPER).
abstract: BACKGROUND
  Registries are essential to obtain information on the whole spectrum of patients with pulmonary embolism (PE). The aim of the Italian Pulmonary Embolism Registry (IPER) is to report on demographics, clinical features, management, and outcomes of patients diagnosed with PE in everyday clinical practice.
  
  
  METHODS
  Patients with confirmed acute PE were enrolled in a web-based registry, in Cardiology, Emergency or Internal Medicine Departments in 47 hospitals in Italy.
  
  
  RESULTS
  Overall, 1716 patients were included, mean age 70 ± 15 years, (14% of the patients were <50 and 43% >75 year old); 57% of female gender and 11.7% hemodynamically unstable at presentation/diagnosis. D-dimer was performed in 1358 patients (80%). Computerized tomographic pulmonary angiogram (CT) was used for diagnosis in the majority of the patients (82.1%), followed by perfusion lung scan (8.6%). Thrombolytic agents were used in 185 (10.8%) patients, percutaneous thrombectomy in 14 (0.8%) and surgery in 2 (0.1%). One hundred sixteen patients died while in-hospital (6.7%), 68 (3.9%) due to PE. Death or clinical deterioration occurred in 138 patients (8.0%). All-cause mortality was 31.8% in hemodynamically unstable patients and 3.4% in hemodynamically stable patients; the corresponding PE-related deaths were 23.3% and 1.4% respectively. Age >75 (HR 1.50, 95% CI 1.01-2.25), immobilization > 3 days before diagnosis of PE (HR 2.54, 95% CI 1.72-3.77) and hemodynamic impairment (HR 6.38, 95% CI 4.26-9.57) were independent predictors for in-hospital death.
  
  
  CONCLUSIONS
  Patients with PE have a considerable risk of death during the hospital stay, PE being the most common cause of early mortality.
authors.affiliation: Cardiologia- Ospedale San Carlo Borromeo, Milan, Italy. fcasazza@tin.it
authors.forename: Franco
authors.initials: F
authors.lastname: Casazza
authors.forename: Cecilia
authors.initials: C
authors.lastname: Becattini
authors.forename: Amedeo
authors.initials: A
authors.lastname: Bongarzoni
authors.forename: Claudio
authors.initials: C
authors.lastname: Cuccia
authors.forename: Loris
authors.initials: L
authors.lastname: Roncon
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Favretto
authors.forename: Pietro
authors.initials: P
authors.lastname: Zonzin
authors.forename: Luigi
authors.initials: L
authors.lastname: Pignataro
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Agnelli
mesh_terms: D000208:Acute Disease; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D012307:Risk Factors; D016896:Treatment Outcome