Clinical presentation and management of pulmonary embolism at a tertiary care hospital of Peshawar, KP, Pakistan

Abstract

Introduction: Pulmonary embolism (PE) is a thrombotic disorder, in which blockage occurs in the pulmonary artery preventing blood flow to the lungs. Objective: To assess the presenting complaints, risk factors and clinical presentation of patients presenting to Rehman Medical Institute (RMI) and the management plan implied in treating these patients.
Materials & Methods: A cross-sectional descriptive study was conducted in Pulmonology Ward of Rehman Medical Institute (RMI) from January 2016 to December 2017. All patients diagnosed with Pulmonary Embolism were included in the study regardless of age or gender, while deceased patients were excluded. Patients were diagnosed using various investigations. Data were collected using a Performa by direct interview from the patients. Consent for data collection was taken from the patients verbally. Data collected were entered in Statistical Package for Social Science (SPSS) version 20.0 and analyzed for descriptive statistics.
Results: A total of 100 patients were assessed in the ward. The male to female ratio was 0.82:1. The mean age of patients was 59.84 ± 18.81 years. The most prevailing risk factor was immobilization or the patient being bedridden (66%). The least common risk factors were recent trauma / Road Traffic Accident (RTA) in the past 3 months (5%), and Warfarin Use (4%). Shortness of breath (96%) was the most significant clinical feature followed closely by Pain (93%). Clexane (37%) was the most common drug used for males while Rivaroxaban (45%) was commonly used in females.
Conclusion: The clinical presentation of PE is generally the same; however, a set of diagnostic investigations cannot be devised due to the variability of results seen in this study. Physicians are urged to keep a low index of suspicion when diagnosing a case of PE.