ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Pulmonary Infarcts in Pulmonary Embolism - Does It Matter?
Session Title
TP88 - TP088 LUCY IN THE SKY WITH DIAMONDS - PULMONARY EMBOLISM, CTEPH, THROMBOSIS, AND COVID19: CLINICAL ADVANCES
Abstract
A3725 - Pulmonary Infarcts in Pulmonary Embolism - Does It Matter?
Author Block: O. A. O'Corragain1, D. Sacher2, T. Ho3, H. Zhao4, G. J. Criner1, P. Rali1; 1Pulmonary and Critical Care, Temple University Hospital, Philadelphia, PA, United States, 2Pulmonary and Critical Care, Temple University Hospital, Phiadelphia, PA, United States, 3Internal Medicine, Temple University Hospital, Philadelphia, PA, United States, 4Clinical Sciences, Temple University Hospital, Philadelphia, PA, United States.
Rationale: Pulmonary infarction is a common radiographic finding in acute pulmonary embolism (PE), seen in up to 30% of patients. Infarction is more commonly associated with distal emboli due to less robust bronchial blood supply. Factors previously associated with pulmonary infarction are age, height, increased BMI, and current smoking. The prognostic significance of pulmonary infarction remains unclear. The aim of this study was to assess demographic factors, evidence of right ventricular dysfunction (RVD), use of reperfusion therapy and outcomes in patients with radiographic evidence of pulmonary infarcts and those without.
Methods: All patients who underwent assessment by the PE response team (PERT) between January 2017 and June 2019 at Temple University Hospital (Philadelphia, PA) were evaluated. Patients were stratified based on the presence of pulmonary infarction on computed tomography (CT) imaging. Patient demographics, comorbidities, treatment and outcomes were assessed. Statistical analysis was performed using Wilcoxon analysis for continuous variables and Fisher's exact test and Chi-Square test for categorical variables.
Results: 300 patients were identified, 103 (34.3%) with evidence of pulmonary infarct on CT imaging with 197 (65.6%) without infarct. Patients with infarction were less likely to have a history of malignancy (10.7% vs 22.3%, p=0.018) or recent surgery (9.7% vs 17.3%, p=0.087). There was no difference in measures of RVD by CT (42.7% vs 41.1%, p=0.71). There was no difference in rates of use of reperfusion therapy (20.4% vs 29.4%, p=0.17). There was no difference in length of stay (9.13 days vs 10.25 days, p=0.47), 30 day readmission (18.4% vs 13.2%, p=0.24) or mortality (3.9% vs 8.1%, p=0.55).
Conclusions: The presence of pulmonary infarction did not assist with PE risk stratification. There was no association with higher rates of RVD or worsened outcomes. The presence of pulmonary infarcts should not be considered a supporting factor for advanced reperfusion therapies for PE.
Author Block: O. A. O'Corragain1, D. Sacher2, T. Ho3, H. Zhao4, G. J. Criner1, P. Rali1; 1Pulmonary and Critical Care, Temple University Hospital, Philadelphia, PA, United States, 2Pulmonary and Critical Care, Temple University Hospital, Phiadelphia, PA, United States, 3Internal Medicine, Temple University Hospital, Philadelphia, PA, United States, 4Clinical Sciences, Temple University Hospital, Philadelphia, PA, United States.
Rationale: Pulmonary infarction is a common radiographic finding in acute pulmonary embolism (PE), seen in up to 30% of patients. Infarction is more commonly associated with distal emboli due to less robust bronchial blood supply. Factors previously associated with pulmonary infarction are age, height, increased BMI, and current smoking. The prognostic significance of pulmonary infarction remains unclear. The aim of this study was to assess demographic factors, evidence of right ventricular dysfunction (RVD), use of reperfusion therapy and outcomes in patients with radiographic evidence of pulmonary infarcts and those without.
Methods: All patients who underwent assessment by the PE response team (PERT) between January 2017 and June 2019 at Temple University Hospital (Philadelphia, PA) were evaluated. Patients were stratified based on the presence of pulmonary infarction on computed tomography (CT) imaging. Patient demographics, comorbidities, treatment and outcomes were assessed. Statistical analysis was performed using Wilcoxon analysis for continuous variables and Fisher's exact test and Chi-Square test for categorical variables.
Results: 300 patients were identified, 103 (34.3%) with evidence of pulmonary infarct on CT imaging with 197 (65.6%) without infarct. Patients with infarction were less likely to have a history of malignancy (10.7% vs 22.3%, p=0.018) or recent surgery (9.7% vs 17.3%, p=0.087). There was no difference in measures of RVD by CT (42.7% vs 41.1%, p=0.71). There was no difference in rates of use of reperfusion therapy (20.4% vs 29.4%, p=0.17). There was no difference in length of stay (9.13 days vs 10.25 days, p=0.47), 30 day readmission (18.4% vs 13.2%, p=0.24) or mortality (3.9% vs 8.1%, p=0.55).
Conclusions: The presence of pulmonary infarction did not assist with PE risk stratification. There was no association with higher rates of RVD or worsened outcomes. The presence of pulmonary infarcts should not be considered a supporting factor for advanced reperfusion therapies for PE.
