Clinical, laboratory characteristics of pulmonary thromboemboli patients and follow-up of treatment complications and recurrence in six month months

Introduction Pulmonary thromboembolism is a disease with high mortality and morbidity, can be recurrent, sometimes it is difficult to diagnose but it is preventable and treatable. In this study, we aimed to evaluate the clinical signs and symptoms, risk factors, laboratory results, clinical scoring and radiological imaging of the patients diagnosed with pulmonary embolism, and the disease and treatment-related complications in the six-month follow-up. We also aimed to detect genetic mutations and thrombophilic conditions in pulmonary embolism patients with acquired risk factors. Materials and Methods The present study was a prospective study in which 60 subjects who had no history of venous thromboembolism (VTE) or anticoagulation use, who presented to the chest diseases policlinic, emergency department or who were diagnosed as pulmonary thromboembolism while hospitalized for another reason. Results The mean age of the subjects was 59.9 ± 18.7 years, 51.6% of them were over 65 years. The most common presenting complaints were shortness of breath and stabbing chest pain. The most common findings were tachypnea and tachycardia. Nearly half of the subjects had at least one comorbid disease. Hypertension and cardiac diseases were the two most common comorbid conditions. There were at least one risk factor in all cases and at least two risk factors in more than half of the cases, while the mean number of risk factors was 2,5. In the genetic analysis of the cases, average 2 mutations were observed in per case and heterozygous mutations were the most common. The most common mutations were plasminogen activator inhibitor type 1 (PAI-1) and methylenetetrahydrofolate reductase (MTFHR) heterozygote mutations. Thrombus localization was mostly in the right main pulmonary artery on computed tomography. Conclusions Pulmonary embolism continues to be a more prevalent disease with increasing age and associated risk factors. Since there is at least one acquired risk factor in all of our cases, we think that almost every patient may have acquired risk factor if the history is deepened. We also think that genetic or thrombophilic conditions may be detected in almost all cases diagnosed with pulmonary embolism. It has been concluded that immobilization and obesity are the most common preventable risk factors associated with VTE and new clinical prediction scores have been developed in diagnostic algorithms. Keywords: Anticoagulants; Deep Vein Thrombosis; Pulmonary Embolism; Risk Factors; Thrombophilia