A. Palla et al., CLINICAL, ANAMNESTIC AND COAGULATION DATA IN PATIENTS WITH SUSPECTED OR CONFIRMED PULMONARY-EMBOLISM, Respiration, 61(2), 1994, pp. 93-98
We studied 84 consecutive patients referred with the suspicion of pulm
onary embolism (PE) to investigate the influence of clinical and hemat
ological profiles on the diagnosis and severity of this disease and re
covery. Diagnosis of PE was confirmed in 48 out of 84 patients by perf
usion scintigraphy and/or pulmonary arteriography. Severity of PE and
entity of recovery were investigated by measuring standard PaO2 on blo
od gas analysis and the number of unperfused lung segments ULS on perf
usion scintigraphy. Most common clinical predisposing conditions were
more frequent, though not significantly so, in embolic patients and a
very low prevalence of PE was appreciable in patients without clear pr
edisposing conditions. Among coagulation factors, only thrombin-antith
rombin (TAT) complexes were twice as high in embolic as in nonembolic
patients (14.0 +/- 13.6 vs. 7.0 +/- 4.2 ng/ml; p < 0.02), while there
was no statistically significant difference between embolic and nonemb
olic patients for activated partial thromboplastin time, prothrombin t
ime, antithrombin III, protein C, fibrinogen, plasminogen, alpha(2)-pl
asmin inhibitor, and plasminogen activator inhibitor-1. Sensitivity an
d specificity of TAT complexes in diagnosis of PE were 95.8% and 30.5%
, respectively. Therefore, normal values of TAT complexes may help exc
lude the diagnosis of PE, while abnormal values allow to reinforce the
clinical suspicion of PE. No relation was found between coagulation p
arameters and the severity of PE. The follow-up of 48 patients with co
nfirmed PE was favorable on the average; however, neither the presence
of predisposing conditions nor abnormal coagulation parameters allow
to predict the degree of functional and scintigraphic improvement duri
ng follow-up.