Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Mar;8(1):e000894.
doi: 10.1136/bmjresp-2021-000894.

Safety and efficacy of catheter directed thrombolysis (CDT) in elderly with pulmonary embolism (PE)

Eneida Harrison  1 , Jin Sun Kim  2 , Vladimir Lakhter  3 , Ka U Lio  4 , Rami Alashram  5 , Huaqing Zhao  6 , Rohit Gupta  7 , Maulin Patel  7 , James Harrison  8 , Joseph Panaro  9 , Kerry Mohrien  10 , Riyaz Bashir  3 , Gary Cohen  9 , Gerard Criner  5 , Parth Rali  5
Affiliations
Observational Study

Safety and efficacy of catheter directed thrombolysis (CDT) in elderly with pulmonary embolism (PE)

Eneida Harrison et al. BMJ Open Respir Res. 2021 Mar.

Abstract

Introduction: Acute pulmonary embolism (PE) remains a common cause for morbidity and mortality in patients over 65 years. Given the increased risk of bleeding in the elderly population with the use of systemic thrombolysis, catheter-directed therapy (CDT) is being increasingly used for the treatment of submassive PE. Nevertheless, the safety of CDT in the elderly population is not well studied. We, therefore, aimed to evaluate the safety of CDT in our elderly patients.

Methods: We conducted a retrospective observational study of consecutive patients aged >65 years with a diagnosis of PE from our Pulmonary Embolism Response Team database. We compared the treatment outcomes of CDT versus anticoagulation (AC) in elderly. Propensity score matching was used to construct two matched cohorts for final outcomes analysis.

Results: Of 346 patients with acute PE, 138 were >65 years, and of these, 18 were treated with CDT. Unmatched comparison between CDT and AC cohorts demonstrated similar in-hospital mortality (11.1% vs 5.6%, p=0.37) and length of stay (LOS) (3.81 vs 5.02 days, p=0.5395), respectively. The results from the propensity-matched cohort mirrored results of the unmatched cohort with no significant difference between CDT and AC in-hospital mortality (11.8% vs 5.9%, p=0.545) or median LOS (3.76 vs 4.21 days, p=0.77), respectively.

Conclusion: In this observational study using propensity score-matched analysis, we found that patients >65 years who were treated with CDT for management of acute PE had similar mortality and LOS compared with those treated with AC. Further studies are required to confirm these findings.

Keywords: pulmonary embolism.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Bauersachs RM. Use of anticoagulants in elderly patients. Thromb Res 2012;129:107–15. 10.1016/j.thromres.2011.09.013 - DOI - PubMed
    1. Tritschler T, Aujesky D. Venous thromboembolism in the elderly: a narrative review. Thromb Res 2017;155:140–7. 10.1016/j.thromres.2017.05.015 - DOI - PubMed
    1. Polo Friz H, Molteni M, Del Sorbo D, et al. . Mortality at 30 and 90 days in elderly patients with pulmonary embolism: a retrospective cohort study. Intern Emerg Med 2015;10:431–6. 10.1007/s11739-014-1179-z - DOI - PubMed
    1. Konstantinides SV, Meyer G, Becattini C, et al. . 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European respiratory Society (ERS). Eur Heart J 2020;41:543–603. 10.1093/eurheartj/ehz405 - DOI - PubMed
    1. Meyer G, Vicaut E, Danays T, et al. . Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med Overseas Ed 2014;370:1402–11. 10.1056/NEJMoa1302097 - DOI - PubMed

Publication types

Substances

LinkOut - more resources