title: Symptomatic pulmonary embolism among stroke patients in Taiwan: a retrospective cohort study.
abstract: BACKGROUND
  Stroke patients are at particular risk for developing pulmonary embolism (PE), which is a cardiovascular emergency associated with a high mortality rate. Little information is available on symptomatic PE in Asian stroke patients.
  
  
  OBJECTIVE
  To determine the frequency of symptomatic PE in ischemic and hemorrhagic stroke patients; to identify common characteristics and risk factors of symptomatic PE in Taiwanese stroke patients; and to compare the difference between fatal PE and nonfatal PE among these stroke patients.
  
  
  METHODS
  This is a retrospective cohort study of stroke patients admitted between January 2002 and December 2009 to a tertiary referral center in Northern Taiwan. We used the International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify eligible patients. We determined annual frequency and risk factors of symptomatic PE. We also compared the difference between ischemic stroke patients with fatal and nonfatal PE.
  
  
  RESULTS
  Among the admitted stroke patients, 21,129 (78.87%) had ischemic strokes and 5,662 (21.13 %) had hemorrhagic strokes. There were 14 (0.066%) ischemic and 1 hemorrhagic stroke (0.018%) patients included in this study. Of the recruited stroke patients, 64.29% had past heart disease history, especially atrial fibrillation (42.86%). Patients with fatal PE showed a significantly lower poststroke Glasgow Coma Scale (GCS) motor component than patients with nonfatal PE.
  
  
  CONCLUSIONS
  Symptomatic PE is not common in stroke patients in Taiwan. Clinicians need to keep this fatal disease in mind, especially for persons with heart disease like atrial fibrillation. Stroke patients with impaired poststroke GCS motor components seemed to have a greater mortality risk if they have symptomatic PE.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Chen
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Chung
authors.forename: Wei-Han
authors.initials: WH
authors.lastname: Chang
authors.forename: Jia-Pei
authors.initials: JP
authors.lastname: Hong
authors.forename: Li-Ting
authors.initials: LT
authors.lastname: Huang
authors.forename: Simon F T
authors.initials: SF
authors.lastname: Tang
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000208:ethnology / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000208:ethnology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000208:ethnology* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology* / Q000401:mortality*; D000071939:Stroke Rehabilitation; D013624:Taiwan / Q000453:epidemiology; D020246:Venous Thrombosis / Q000208:ethnology / Q000401:mortality