Esra ARSLAN, Meftun ÜNSAL, Özgür İNCE, Müfit BAKIRCI, Servet KAYHAN

Delays in diagnosis of acute pulmonary thromboembolism: clinical outcomes and risk factors

Akut pulmoner tromboemboli sık görülen ve ölümcül bir hastalıktır. Pulmoner emboli tanısında gecikmenin klinik önemiyle il- gili araştırmaya ihtiyaç duyulmaktadır. Ocak 2009 ile Aralık 2010 arasında kliniğimizde pulmoner tromboemboli tanısı konulan ardışık 189 hasta çalışmaya alınmıştır. Tanısal gecikmenin nedenleri ve süresi konusunda hastaların yaş, cinsiyet, eğitim düzeyi, sigara içme durumu, Wells skorları, semptomları, embolinin tipi, radyolojik ve klinik bulguları ayrıca ilk başvurulan sağlık ku- rumundan sevk gecikmesi gibi değişkenler retrospektif olarak araştırılmıştır. Çalışmaya alınan hastaların 104(%55)ü kadın ve 85(%45)i erkekti. Yaş ortalaması 57,95 (19-88 aralığında), ortalama tanısal gecikme süresi 7.9± 15.2 (ortanca değer 3 gün ve 1-120 aralığında), sağlık kurumundan sevk gecikme süresi ise ortalama 0.5± 3.9 gün (ortanca değer 0 gün ve 0-15 aralığında) bulundu. 70 (%37,04) hastada semptom başlangıcından sonra 7 günden daha uzun süreli tanısal gecikme olduğu saptandı. Sigara içenler, başvuru sırasında Wells skoru 4 ve daha düşük olanlar ile BT anjiyografide masif emboli bulgusu olmayanlar tanısal gecikme ile ilişkiliydi (p

Akut akciğer tromboemboli tanısında gecikme: Klinik sonuçlar ve risk faktörleri

Acute pulmonary thromboembolism is a common and potentially lethal disease. There is limited information about clinical im- portance of the delay in pulmonary embolism diagnosis. Between January 2009 and December 2010, consecutive 189 patients with PTE were enrolled to this retrospective study. Varriables including age, sex, educational level, smoking, Wells scores, symptoms, embolism types, clinical and radiological findings were analyzed for delay in diagnosis. Study group consisted of 104 (55%) female and 85 (45%) male patients. The mean age of the group was 57,95 (range 19-88) years. The mean time to presantation or patient delay was 7.9± 15.2 (median 3 days; range, 1-120) days. Diagnostic delay caused by initial misdiagnosis of the health care provid- ers was 0.5± 3,9 (median 0; range 0-45) days. Seventy (37,04%) patients had a delay in diagnosis longer than seven days after onset of symptoms of pulmonary embolism. Current smokers, patients with low Wells scores(≤4) and having non spesific CT pulmonary angiographic findings for PTE at the first admission associated with delay in diagnosis in the present study (p

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