EDITORIALS
Role of thrombolysis in haemodynamically stable patients with pulmonary embolism
1 Royal Brompton Hospital, London, UK
2 Chelsea and Westminster Hospital, London, UK
Correspondence to:
Dr Pallav L Shah, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; pallav.shah@imperial.ac.uk
| The first 150 words of the full text of this article appear below. |
Pulmonary embolism (PE) is a common cardiopulmonary illness with an age and sex adjusted incidence of approximately 117 cases per 100 000 person years.1 Incidence rises sharply after the age of 60 years in both men and women. While mortality rates exceed 15% in the 3 months following diagnosis, they are reduced to 2–10% if PE is diagnosed and treated promptly.2 3 The majority of patients with PE are haemodynamically stable at presentation and receive anticoagulation with heparin. By contrast, thrombolysis (or embolectomy) is the accepted standard of care in those patients who present with haemodynamic compromise.4 Under such circumstances, mortality approaches 50% and although to date no study has been powered to show a mortality benefit, such treatment potentially outweighs the complication rate of 3%.2 5 Importantly, it is now recognised that there is another cohort of patients who, although haemodynamically stable, are nevertheless at an increased risk of death and
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