Stoeva N, et al. - Researchers sought to investigate the clinical presentation and short-term prognosis of unprovoked pulmonary embolism (PE) in comparison to provoked PE in order to achieve an improved recognition of PE. They reported the occurrence of unprovoked PE at a younger age, more frequently in males. In comparison to provoked PE, unprovoked PE was characterized by certain significant variables such as higher Wells score, lower pulmonary embolism severity index (PESI) score, lower C-reactive protein, higher thrombotic burden and lower one-month mortality rate.

Methods

• A total of 331 patients with PE, approved by computer tomographic pulmoangiography, were included in this prospective observational study.
• Based on their epidemiological data, participants were categorized as having unprovoked or provoked PE.
• Both groups were compared for clinical characteristics and one-month mortality rate.

Results

• Data showed that provoking factors were detected in about 67% of the patients and ~33% had unprovoked PE.
• The unprovoked PE-group, compared to provoked PE-group, comprised younger patients (56.67 ± 17.95 vs 63.76 ± 14.58, p < .0001) with male predominance (62.04% vs 37.96%, p=.012).
• More previous thromboembolic events were reported among the patients with unprovoked PE compared to provoked PE-group (30.56% vs 19.45%, p=.022), with a larger thrombotic burden (p=.001).
• In addition, similar frequencies of dyspnea (85.18% vs 85.13%), chest pain (47.22% vs 46.85%), cough (43.92% vs 45.94%), hemoptysis (16.67% vs 14.41%), hemodynamic instability (9.26% vs 8.56%), deep venous thrombosis (49.51% vs 44.5%) were reported in both groups.
• Researchers did not find any significant differences in the means of systolic pressure of arteria pulmonalis, D-dimer, arterial blood gases, Revised Geneva probability score.
• Unprovoked PE-group had lower 1-month mortality than provoked group (1.85% vs 8.52%, p=.042).