Prognosis
Anticoagulant therapy is usually successful effective in preventing new thrombus formation. However there is the risk of emboli from an existing clot for several days after starting treatment.
The lung healing is usually complete. There may be pleural adhesions which cause painful tethering of the chest and a reduction in vital capacity, and haemoptysis may continue for some weeks after treatment has begun.
In patients with acute PE, hypotension (systolic BP <90 mmHg) is associated with increased mortality - often due to cardiogenic shock secondary to right ventricular (RV) collapse. (1)
Using the simplified Pulmonary Embolism Severity Index, patients in the high-risk category have a short-term mortality of 10.9%, while patients in the low-risk category have 30-day mortality of 1%. (2)
Reference
- Coutance G, Cauderlier E, Ehtisham J, Hamon M, Hamon M. The prognostic value of markers of right ventricular dysfunction in pulmonary embolism: a meta-analysis. Crit Care. 2011;15(2):R103.
- Zhou XY, Ben SQ, Chen HL, et al. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis. Respir Res. 2012 Dec 4;13:111.
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