Pulmonary embolism risk factors for intensive care unit anticoagulated COVID-19 patients undergoing computed tomography angiography
OBJECTIVE: To assess pulmonary embolism incidence, its relationship with D-dimer levels and other possible associated factors in addition to anticoagulation and contrast medium adverse effects.
METHODS: A retrospective observational cohort study at a Chilean public hospital was performed. Intensive care unit mechanically ventilated COVID-19 patients older than 18 years old between March and June 2020 were included. All patients received heparin thromboprophylaxis, which was increased to the anticoagulation dose with D-dimer greater than 3µg/mL.
RESULTS: A total of 127 patients were followed up, of whom 73 underwent pulmonary computed tomography angiography (mean age, 54 ± 12 years; 49 men). Sixty-two of the 73 patients (84.9%) received full anticoagulation before computed tomography angiography. In addition, 18 of the 73 patients had pulmonary embolism (24.7%). When comparing patients with and without pulmonary embolism, no significant differences were observed in age, sex, obesity, smoking, Wells and revised Geneva scores, D-dimer or mortality. Anticoagulant use was similar in both groups. Days from the start of anticoagulation until computed tomography angiography were significantly lower in the pulmonary embolism group (p = 0.002). Three patients presented post contrast-acute kidney injury (4.1%), and one patient had major bleeding.
CONCLUSION: Despite anticoagulation, one in four COVID-19 patients connected to mechanical ventilation and evaluated with pulmonary computed tomography angiography had pulmonary embolism. With a longer the delay in performing computed tomography angiography once empirical anticoagulation was started, significantly less pulmonary embolism was identified.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Revista Brasileira de terapia intensiva - 33(2021), 3 vom: 22., Seite 346-352 |
| Sprache: |
Portugiesisch |
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| Weiterer Titel: |
Fatores de risco para embolia pulmonar em pacientes com COVID-19 anticoagulados na unidade de terapia intensiva submetidos à angiografia por tomografia computadorizada |
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| Beteiligte Personen: |
Briceño-Mayorga, Gonzalo Patricio [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 04.02.2022 Date Revised 14.04.2023 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.5935/0103-507X.20210053 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336411200 |
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| 245 | 1 | 0 | |a Pulmonary embolism risk factors for intensive care unit anticoagulated COVID-19 patients undergoing computed tomography angiography |
| 246 | 3 | 3 | |a Fatores de risco para embolia pulmonar em pacientes com COVID-19 anticoagulados na unidade de terapia intensiva submetidos à angiografia por tomografia computadorizada |
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| 500 | |a Date Completed 04.02.2022 | ||
| 500 | |a Date Revised 14.04.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To assess pulmonary embolism incidence, its relationship with D-dimer levels and other possible associated factors in addition to anticoagulation and contrast medium adverse effects | ||
| 520 | |a METHODS: A retrospective observational cohort study at a Chilean public hospital was performed. Intensive care unit mechanically ventilated COVID-19 patients older than 18 years old between March and June 2020 were included. All patients received heparin thromboprophylaxis, which was increased to the anticoagulation dose with D-dimer greater than 3µg/mL | ||
| 520 | |a RESULTS: A total of 127 patients were followed up, of whom 73 underwent pulmonary computed tomography angiography (mean age, 54 ± 12 years; 49 men). Sixty-two of the 73 patients (84.9%) received full anticoagulation before computed tomography angiography. In addition, 18 of the 73 patients had pulmonary embolism (24.7%). When comparing patients with and without pulmonary embolism, no significant differences were observed in age, sex, obesity, smoking, Wells and revised Geneva scores, D-dimer or mortality. Anticoagulant use was similar in both groups. Days from the start of anticoagulation until computed tomography angiography were significantly lower in the pulmonary embolism group (p = 0.002). Three patients presented post contrast-acute kidney injury (4.1%), and one patient had major bleeding | ||
| 520 | |a CONCLUSION: Despite anticoagulation, one in four COVID-19 patients connected to mechanical ventilation and evaluated with pulmonary computed tomography angiography had pulmonary embolism. With a longer the delay in performing computed tomography angiography once empirical anticoagulation was started, significantly less pulmonary embolism was identified | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Sotomayor, Celine |e verfasserin |4 aut | |
| 700 | 1 | |a Ebner, Matías |e verfasserin |4 aut | |
| 700 | 1 | |a Allende, Felipe |e verfasserin |4 aut | |
| 700 | 1 | |a Assar, Rodrigo |e verfasserin |4 aut | |
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