PB0943 - Clinical characteristics and mortality of older patients diagnosed with acute pulmonary embolism on the emergency department, compared to other older patients in the emergency department

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

DA

Denise Abbel

MSc
Department of Internal Medicine – section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands

Co-Author(s)

Dieuwke Luijten, MD, PhD cadidate

Department of Medicine - Thrombosis & Hemostasis, Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
Suzanne C. Cannegieter

MD, PhD, prof
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Leiden, Zuid-Holland, Netherlands
JG

Jacobijn Gussekloo

MD, PhD, prof
Department of Internal Medicine – section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
MH

Menno V. Huisman

Professor of Medicine
Department of Medicine – Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands; Dutch Thrombosis Network, The Netherlands.
Leiden, Zuid-Holland, Netherlands
Jeroen Eikenboom

MD, PhD, prof
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
Pd

Paul L. den Exter

Hematologist
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
Leiden, Zuid-Holland, Netherlands
Tv

Thijs E. van Mens

MD, PhD
Department of Medicine - Thrombosis & Hemostasis, Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
LT

Lara Tahir

BSc
Department of Internal Medicine – section of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
ST

Stella Trompet

PhD
Department of Internal Medicine – section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
SM

Simon Mooijaart

MD, PhD, prof
Department of Internal Medicine – section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
Erik Klok, MD, PhD, FESC

Leiden University Medical Center

Background: The risk of pulmonary embolism (PE) increases with age, but little is known about the geriatric characteristics, including functioning and cognition, of older PE patients. A comprehensive understanding of epidemiologic and clinical features of older patients with acute PE will enhance the formulation and decision process of individualized care and treatment in older patients with acute PE.

Aims: To describe the clinical and geriatric characteristics, including functioning and cognition, of older patients diagnosed with acute PE in the emergency department (ED), as well as their mortality outcomes, and compare these to other older patients evaluated at the ED.

Methods: We used data from the following two cohort studies: 194 PE patients aged 70 and older who visited the ED between 2015 and 2021 and 751 patients aged 70 and older from the Acutely Presenting Older Patient (APOP) study who visited the ED in 2014. Baseline characteristics, characteristics during hospital stay and 3 months follow-up outcomes were retrieved from electronic patient records and compared between the two cohort studies using descriptive analyses.

Results: PE patients had a lower prevalence of polypharmacy (n=99 (51%)) vs n=441(59%)), dementia (n=6 (3.1%)) vs n=34 (4.5%)), ADL dependency (n=45 (37.2%) vs n=145 (45.3%)), high risk APOP score (n=11 (13.9%) vs n=124 (16.6%)), and scored higher at functioning and cognitive APOP sub questions compared to other older patients. PE patients had a higher in hospital mortality (n=18 (9.3%) vs n=12 (4.4%)), 3-month mortality (n=33 (17%) vs n=71 (9.5%)) and 12-month mortality (n=50 (26%) vs n=135 (18%)) compared to other older patients.

Conclusion(s): Compared to other older patients admitted to our hospital via the ED, PE patients had better functioning and cognitive scores, but higher mortality. The higher mortality might be explained by the severity of the PE and/or underlying morbidity despite a better geriatric performance.