MedWire News: Thrombolysis may lead to a reduction in the length of hospitalization for patients with intermediate-risk pulmonary embolism (PE), German researchers report.
"Although influenced by many factors, the length of hospitalization might be an appropriate indicator for the effectiveness of thrombolytic therapy in patients with PE, since both potential clinical benefits as well as complications will affect the length of stay (LOS)," say Thomas Berghaus (Ludwig- Maximilians-University Munich, Augsburg) and colleagues.
In the present study, Berghaus and team identified factors associated with LOS in patients with PE and signs of right ventricular dysfunction (RVD) and/or myocardial injury (the intermediate-risk group). They also investigated whether LOS is suitable to assess effectiveness of thrombolysis in this group of patients.
The team reviewed data from 202 patients, 84 of whom received heparin plus thrombolysis with alteplase and 118 who were treated with anticoagulants alone.
The researchers report that clinical worsening was less common and the incidence of minor bleeding was more common in patients who received thrombolysis, compared with patients who only received anticoagulants.
They add that in-hospital mortality was significantly lower in patients receiving thrombolysis and these patients were more frequently discharged home without further treatment than patients receiving anticoagulants alone.
Furthermore, the total median LOS in hospital was significantly shorter in the thrombolysis group, compared with the anticoagulant-only group, at 10 days versus 12 days, respectively. In contrast, there was no difference between the groups in the LOS in the intensive care unit.
Multivariate analyses revealed that age above 65 years and presence of comorbidities were independent predictors of a prolonged hospital stay, whereas thrombolysis independently predicted a shorter total LOS and reduced in-hospital mortality.
"Postulating that a shorter total LOS results from a more effective therapy, we speculate that thrombolytic treatment may be more effective than anticoagulant therapy alone in normotensive patients with acute PE and signs of RVD," Berghaus and co-authors conclude in the journal Advances in Therapy.
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