PMID- 22705059
OWN - NLM
STAT- MEDLINE
DCOM- 20130131
LR  - 20120821
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 130
IP  - 3
DP  - 2012 Sep
TI  - Rapid improvement of renal function in patients with acute pulmonary embolism 
      indicates favorable short term prognosis.
PG  - e37-42
LID - 10.1016/j.thromres.2012.05.032 [doi]
AB  - OBJECTIVE: Various clinical and biochemical parameters predict the prognosis of 
      patients with acute pulmonary embolism(APE). Treatment of APE can improve a 
      patient's hemodynamic status, restoring adequate peripheral organ perfusion. 
      Therefore, we hypothesized that improvement of renal function can predict short 
      term prognosis of APE patients. MATERIAL & METHOD: We evaluated 232 consecutive 
      patients (94 men,aged 67 +/- 18 years) with APE proven by spiral computer 
      tomography. Blood samples were collected for creatinine assays on admission and 
      72 hours later, the glomerular filtration rate(eGFR) was estimated using the MDRD 
      formula. RESULTS: During the first 72 hours, 6 subjects died, while during the 
      first 30 days 24(10%) subjects died (APE mortality 8%). On admission eGFR<60 
      ml/min was present in 113 patients(49%) and after 72 hours in 85 patients(38%). 
      In 26 patients(11%) eGFR on admission was <60 ml/min and renal function did not 
      improve during subsequent 72 hours. In this group the 30-day all-cause and 
      APE-related mortality rates were 27% and 23%, respectively, while serious adverse 
      events occurred in 38% of them. 206 patients with eGFR>60 ml/min showed a more 
      favorable prognosis (8% 30-day all-cause mortality) than subjects with eGFR<60 
      ml/min and a stable eGFR during the first 72 hours (27% mortality rate, p<0.003). 
      Persistent renal dysfunction predicted all-cause and PE-related 30-day mortality 
      (hazard risk 2.53(CI 95%:0.96-6.68),p=0.06 and 3.04(CI 95%:1.28-7.26),p=0.01, 
      respectively). CONCLUSION: Approximately 50% of patients with APE have at least a 
      moderately impaired renal function on admission. Renal function improves within 
      72 hours in patients with a good prognosis, while "persistent" renal dysfunction 
      indicates an increased mortality.
CI  - Copyright (c) 2012 Elsevier Ltd. All rights reserved.
FAU - Kostrubiec, Maciej
AU  - Kostrubiec M
AD  - Department of Internal Medicine and Cardiology, The Medical University of Warsaw, 
      Poland. maciej.kostrubiec@wum.edu.pl
FAU - Labyk, Andrzej
AU  - Labyk A
FAU - Pedowska-Wloszek, Justyna
AU  - Pedowska-Wloszek J
FAU - Pacho, Szymon
AU  - Pacho S
FAU - Dzikowska-Diduch, Olga
AU  - Dzikowska-Diduch O
FAU - Dul, Przemyslaw
AU  - Dul P
FAU - Ciurzynski, Michal
AU  - Ciurzynski M
FAU - Bienias, Piotr
AU  - Bienias P
FAU - Pruszczyk, Piotr
AU  - Pruszczyk P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120616
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Comorbidity
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Incidence
MH  - Kidney Diseases/*diagnosis/*mortality
MH  - Male
MH  - Poland/epidemiology
MH  - Prognosis
MH  - Pulmonary Embolism/*diagnosis/*mortality
MH  - Recovery of Function
MH  - Reproducibility of Results
MH  - Risk Assessment
MH  - Sensitivity and Specificity
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2012/06/19 06:00
MHDA- 2013/02/01 06:00
CRDT- 2012/06/19 06:00
PHST- 2011/12/15 00:00 [received]
PHST- 2012/05/14 00:00 [revised]
PHST- 2012/05/26 00:00 [accepted]
PHST- 2012/06/19 06:00 [entrez]
PHST- 2012/06/19 06:00 [pubmed]
PHST- 2013/02/01 06:00 [medline]
AID - S0049-3848(12)00270-8 [pii]
AID - 10.1016/j.thromres.2012.05.032 [doi]
PST - ppublish
SO  - Thromb Res. 2012 Sep;130(3):e37-42. doi: 10.1016/j.thromres.2012.05.032. Epub 
      2012 Jun 16.