Analysis of Patients Received Intravenous t-PA with a Diagnosis of Acute Pulmonary Thromboembolism in Emergency Department

Objectives:In this study, it was aimed to analyse the patients received thrombolytic treatment due to PE in emergency department. Methods:Patients admitted to a third level university emergency department and received thrombolytic therapy due to diagnosis of PE for the last 9 years were analyzed retrospectively. Diagnosis PE was determined with computerized tomography angiography (CTA), echocardiography (ECO), Doppler ultrasonography (Doppler USG), and D-dimer. Wells’ score of all patients were calculated from patient charts. Moreover, medical drugs after thrombolytic therapy, complications, and outcome of patients were recorded in the study form. For each patient PESI score was calculated and recorded to predict clinical outcome. Results:Fifty-nine patients were included to this study. Of 59 patients, 30 (50.8%) were female and 29 (49.2%) were male. Mean age was 58.1 (Range: 18-84; SD: 18). Clinical grading of patient cohort revealed; 31 (52.5%) high-risk PE patients and 28 (47.5%) low-risk PE patients. Comorbidities of the patients, main complaints at emergency department admissions, risk factors for PE, and electrocardiographic findings at emergency department were examined. Basic demographic and clinical data of the patients were listed. Arterial blood gas analysis, complete blood count, biochemical parameters, troponin, and d-dimer levels were recorded. Complications following r-tPA treatment were; hematuria in 2 patients, hemoptysis in 1 patient, subcutaneous hematoma in three patients, and rectus sheet hematoma in one patient. Conclusion:In our opinion, the most important finding of this study is that; there are no significant differences between high and low risk PE groups in terms of thrombolytic treatment process and complications with the exception of PESI scores which have been found to be higher in high-risk PE group. There is need for prospective studies with larger patient cohorts to evaluate the use of thrombolytic agents in emergency department and their effects