title: Effectiveness and safety of thrombolytic therapy in elderly patients with pulmonary embolism.
abstract: Pulmonary embolism (PE) is a major cause of cardiovascular death. Thrombolytic therapy was shown to reduce mortality, especially in high risk patients. In elderly patients (>65 years old) with PE, thrombolytic therapy may be underused due to risk of hemorrhagic complications. In this study, we aimed to assess the effectiveness and safety of thrombolytic therapy among elderly patients with PE. 363 patients (205 subjects in study group, 158 subjects in control group) who were admitted to our hospital with PE were enrolled to the study. The patients were divided into subgroups according to their age and treatment strategy. Mortality rates and bleeding complications according to TIMI bleeding criteria in 30 days and 1-year were analyzed. In elderly patients, total mortality (7.8 vs. 20.1 %, p = 0.05) and mortality at 1-year follow-up (1.9 vs. 12.9 %, p = 0.03) was significantly lower in patients who received thrombolytic treatment. Difference in total bleeding (9.8 vs. 4.5 %, p = 0.18) and major bleeding (3.9 vs. 0.6 %, p = 0.10) in thrombolytic and non-thrombolytic groups was non-significant. Thrombolytic therapy is associated with lower mortality and acceptable bleeding complication rates in PE patients older than 65 years old.
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Göktürk
authors: G
authors: İpek
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Mehmet Baran
authors: MB
authors: Karataş
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Tolga
authors: T
authors: Onuk
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey. drbarisgungor@gmail.com.
authors: Barış
authors: B
authors: Güngör
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Burcu
authors: B
authors: Yüzbaş
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Muhammed
authors: M
authors: Keskin
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Ozan
authors: O
authors: Tanık
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Ahmet
authors: A
authors: Oz
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Mert İlker
authors: Mİ
authors: Hayıroğlu
authors: Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Tıbbiye Caddesi, No: 13, Haydarpaşa, Üsküdar, İstanbul, Turkey.
authors: Osman
authors: O
authors: Bolca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D015996:Survival Rate; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*
keywords: Bleeding; Elderly; Mortality; Pulmonary embolism; Thrombolytic