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Clinical question: Does the presence of deep vein thrombosis (DVT) in patients with pulmonary embolism (PE) have any prognostic value?

Background: There are variable mortality rates among patients with PE because of heterogeneous presentations. Concomitant DVT in patients with PE has an uncertain prognostic significance.

Study design: Prospective cohort study.

Setting: Hospital ED in Madrid, Spain.

Synopsis: Adult outpatients from the ED who underwent evaluation for possible acute PE from January 2003 through October 2007 were screened for DVT. Patients with a history of previous venous thromboembolism (VTE) were excluded.

The primary outcome of the study was all-cause mortality. Secondary outcomes included PE-specific mortality and recurrent symptomatic VTE.

Patients with concomitant DVT had an increased risk for recurrent VTE, along with increased risk of all-cause mortality and PE-specific mortality compared with those without concomitant DVT.

Bottom line: Assessment of the presence of absence of DVT can assist in risk stratification of patients with acute PE.

Citation: Jimenez D, Aujesky D, Diaz G, et al. Prognostic significance of deep vein thrombosis in patients presenting with acute symptomatic pulmonary embolism. Am J Respir Crit Care Med. 2010;181(9):983-991.

Reviewed for TH eWireby Alexander R. Carbo, MD, SFHM; Lauren Doctoroff, MD; John Fani Srour, MD; Matthew Hill, MD; Nancy Torres-Finnerty, MD, FHM; Anita Vanka, MD; Hospital Medicine Program, Beth Israel Deaconess Medical Center, Boston.

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