Incidence of Pulmonary Embolism with Concomitant Deep Vein Thrombosis at an Urban Community Teaching Hospital

Introduction

Though venous thromboembolism (VTE) is thought to be under-diagnosed, roughly 900,000 people are estimated to be affected by VTE each year in the U.S. According to CDC figures, VTE accounts for roughly 60,000 to 100,000 annual deaths. Recent research has demonstrated that the risk of mortality in patients with pulmonary embolism (PE) who were found to have concomitant deep vein thrombosis (DVT) was higher in comparison to patients with PE who did not have concomitant DVT (Beccatini et al. Chest 2015). We have sought to evaluate the risk of concomitant DVT among patients diagnosed with PE in our hospital population.

Methods

This is an ongoing retrospective cohort study examining the incidence of PE with concomitant DVT among patients admitted to an urban community teaching hospital between January 2011 and March 2015. Radiological findings for patients who underwent computed tomography angiography (CTA) and venous duplex ultrasound were reviewed. Patients found to have PE were sub-divided into two groups: those with concomitant DVT and those without concomitant DVT. Mortality risk, correlation with inferior vena cava (IVC) filter placement, and association with other comorbidities continue to be evaluated.

Results

Results of 1,777 CTAs were reviewed of which 160 demonstrated a positive finding of PE: 103 women (64.4%) and 57 men (35.6%). Patient age ranged from 19 to 97 years old. The mean and median ages for all PE-positive patients were 61.9 and 63,respectively. Several patients demonstrated multiple emboli; to wit, 273 distinct PEs were noted among the 160 individual patients. Of the 160 patients with PE, 81 were found to have concomitant DVT (50.6%).

Discussion

The combination of high mortality and rapid-though often overlooked-onset make VTE a uniquely vexing condition. Though the nature of the relationship between DVT and the increased mortality risk among patients with PE is unclear, the correlation has been convincingly demonstrated by prior research and may signal the need for more aggressive management for patients with concomitant thromboemboli. Our findings, consistent with the literature, suggest that the prevalence of concomitant PE and DVT may be substantial in the hospitalized population.