what’s important in PE? location, location, location

28 Feb

nice post from PulmCCM.org: “Forget “embolic burden” of pulmonary embolism: location is everything”



multicenter study out of Europe, 579 patients with acute symptomatic PE

Emboli were:

  • central in 60%,
  • lobar in 25%,
  • distal in 15%,
  • saddle in 13.5%,
  • subsegmental in 4.8%,

bilateral in 77%

Overall, 5.9% died and 4.5% had clinical deterioration (10.4% combined)

In hemodynamically stable patients

  • central PE was an independent predictor (HR 8.3, 1.0 to 67) of death or deterioration; 8.4% died or had clinical deterioration,
  • lobar PE was nearly so (HR 7.57, 0.95 to 60); 7.8% died or had clinical deterioration,
  • distal PE was associated with lower risk (HR 0.12, 0.01 to 0.97); 2.6% died or had clinical deterioration,

overall burden of PE was not associated with worse outcome



central or lobar PE’s are bad, distal PE’s not so much.

total clot burden seems to matter less than location of the clot


References: post; picture


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