Acute pulmonary embolism : clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER).
Background Pulmonary embolism (PE) remains poorly understood.
Rates of clinical outcomes such as death and recurrence vary widely among trials.
We therefore established the International Cooperative Pulmonary Embolism Registry (ICOPER), with the aim of identifying factors associated with death.
Methods 2454 consecutive eligible patients with acute PE were registered from 52 hospitals in seven countries in Europe and North America.
The primary outcome measure was all-cause mortality at 3 months.
The prognostic effect of baseline factors on survival was assessed with multivariate analyses.
Findings 2110 (86.0%) patients had PE proven by necropsy, high-probability lung scan, pulmonary angiography, or venous ultrasonography plus high clinical suspicion ; ICOPER accepted without independent review diagnoses and interpretation of imaging provided by participating centres ; 3-month follow-up was completed in 98.0% of patients.
The overall crude mortality rate at 3 months was 17.4% (426 of 2454 deaths, including 52 patients lost to follow-up) : 179 of 397 (45.1%) deaths were ascribed to PE and 70 of 397 (17.6%) to cancer, and no information on the cause of death was available for 29 patients.
After exclusion of 61 patients in whom PE was first discovered at necropsy, the mortality rate at 3 months was 15.3% (365 of 2393 deaths).
On multiple-regression modelling, age over 70 years (hazard ratio 1.6 [95% CI 1.1-2.3]), cancer (2.3 [1.5-3.5]), congestive heart failure (2.4 [1.5-3. (...)
Mots-clés Pascal : Embolie pulmonaire, Facteur risque, Epidémiologie, Pronostic, Mortalité, Récidive, Homme, Registre, International, Appareil respiratoire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Pulmonary embolism, Risk factor, Epidemiology, Prognosis, Mortality, Relapse, Human, Register, International, Respiratory disease, Cardiovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0240142
Code Inist : 002B11C. Création : 16/11/1999.