title: Clinical Characteristics and Prognosis of Pulmonary Embolism Caused by Economy Class Syndrome.
abstract: OBJECTIVE
  Clinical presentation and short-term prognosis of patients with travel-associated acute pulmonary embolism (PE) (i.e., economy class syndrome [ECS]) is not well understood.
  
  
  METHODS
  In this retrospective cohort study of patients with acute PE identified from a single center registry, we assessed the clinical presentation and the association between ECS and the outcomes of all-cause mortality, PE-related mortality, nonfatal venous thromboembolism and nonfatal major bleeding rates through 30days after initiation of PE treatment.
  
  
  RESULTS
  Of the 2,333 patients with acute symptomatic PE, 124 (5.3%; 95% confidence interval, 4.4-6.3%) had ECS. Patients with ECS were younger and had fewer comorbid diseases (recent bleeding, chronic obstructive pulmonary disease, congestive heart failure), but they presented with more signs of clinical severity (syncope [48% vs. 14%; P<.001], tachycardia [37% vs. 21%; P<.001], right ventricular dysfunction [31% vs. 19%; P<.01] and myocardial injury [57% vs. 28%; P<.001]) compared to those without ECS. Regression analyses showed a significantly lower risk of all-cause mortality for patients with ECS compared to patients without ECS (1.6% vs. 9.6%; P<.01). We did not detect a difference in PE-related mortality at 30days between those with and those without ECS (0.8% vs. 3.1%; P=.18).
  
  
  CONCLUSIONS
  PE patients with ECS are younger and have fewer comorbid diseases compared to those without ECS. Though they present with more signs of clinical severity, their short-term prognosis is excellent.
authors.affiliation: Servicio de Cardiología, Hospital Ramón y Cajal, IRYCIS, Madrid, España.
authors.forename: María
authors.initials: M
authors.lastname: Abellás
authors.affiliation: Medicina Familiar y Comunitaria, Hospital Ramón y Cajal, IRYCIS, Madrid, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Menéndez
authors.affiliation: Servicio de Neumología, Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España.
authors.forename: Raquel
authors.initials: R
authors.lastname: Morillo
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario Virgen del Rocío, CIBERES, Sevilla, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Jara-Palomares
authors.affiliation: Servicio de Neumología, Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España.
authors.forename: Deisy
authors.initials: D
authors.lastname: Barrios
authors.affiliation: Servicio de Neumología, Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Nieto
authors.affiliation: Servicio de Neumología, Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España.
authors.forename: Esther
authors.initials: E
authors.lastname: Barbero
authors.affiliation: Servicio de Urgencias, Hospital Ramón y Cajal, IRYCIS, Madrid, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Corres
authors.affiliation: Servicio de Urgencias, Hospital Clínico San Carlos, IdISSC, Madrid, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ruiz-Artacho
authors.affiliation: Servicio de Neumología, Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España. Electronic address: djimenez.hrc@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Jiménez
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000401:Aircraft; D015897:Comorbidity; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D014195:Travel; D014682:Vena Cava, Inferior
chemical_list: D006495:Heparin, Low-Molecular-Weight
keywords: Economy-class syndrome; Prognosis; Pronóstico; Pulmonary embolism; Síndrome de clase turista; Tromboembolia de pulmón