Diagnosis and Management of Postoperative Acute Pulmonary Embolism after Thoracic Surgeries - Experience of Diagnosis and Management for 37 Patients with Postoperative Acute Pulmonary Embolism after Thoracic Surgeries

Abstract

Background and objective Pulmonary embolism (PE) is one of the most severe complications after thoracic surgeries. Thus it is of great importance to learn the characteristics of acute PE after thoracic surgeries. This study summarized the clinical characteristics and experience on the diagnosis and treatment of 37 patients with postoperative acute pulmonary embolism, in order to improve its prophylaxis and management level. Methods We retrospectively reviewed 37 patients with postoperative acute pulmonary embolism following thoracic surgeries. Age, gender, body mass index (BMI), diagnosis, surgical procedure, onset time, clinical presentation, diagnosis and management were comprehensively analyzed. Results There were 16 males (43.2%) and 21 females (56.8%). The average age was (65.64±6.29) years (range from 53 years to 82 years) and 32 patients were over 60 years. BMI ranged from 17.1 kg/m2 to 30.8 kg/m2 with median of 26.3 kg/m2. And 27 patients’ BMI (73.0%) were over 25.0 kg/m2. Thirty-four patients (91.9%) were with malignancies. Median presentation time was the 4th day postoperatively, while 11 patients were presented on the 3rd day postoperatively which accounted for the most. Patients with acute pulmonary embolism accounted for 77.8% from 9 am to 9 pm. D-dimer (D-D) ranged from 1.0 μg/mL-20.0 μg/mL (FEU) with median of (7.09±4.45) μg/mL (FEU) and 32 (86.5%) patients’ D-D were over 3.00 μg/mL (FEU). Conclusion The survival rate of postoperative acute pulmonary embolism can be increased by fully understanding its clinical characteristics, early diagnosis and multiple disciplinary treatment.

Keywords

• Thoracic surgery
• Pulmonary embolism
• Pulmonary thromboembolism
• Venous thromboembolism