Poster Presentation

Venous thromboembolism (VTE) which comprises pulmonary embolism (PE) and deep vein thrombosis (DVT) has been a public health concern for several years. VTE accounts for an estimated 60,000 to 100,000 deaths per year in the United States. Specifically, patients who present with an acute PE, it has been estimated 25% of these patients have sudden death as the first symptom. Clinical presentation of an acute PE can manifest as nonspecific symptoms which may include: chest pain, cough, hemoptysis, dyspnea, tachypnea, shortness of breath, wheeze, and some patients may present in cardiopulmonary arrest. Severe acute PE can be classified as either massive or submassive PE. A patient with a massive PE would present with signs and symptoms of shock and persistent arterial hypotension. Patients with submassive PE present with hemodynamic stability but positive biomarkers (troponin and BNP) and right ventricular dysfunction. Patients who present with PE are at higher risk of death and adverse outcomes with increasing severity of illness and thrombolytic therapy is indicated in massive PE and may be frequently utilized in submassive PE. Prior studies have identified APACHE II score and need for mechanical ventilation as predictors of mortality in ICU patients, while thrombolytic therapy was identified as protective, however, the urgency of thrombolytic therapy administration has not been evaluated in severely ill patients. The purpose of this study is to evaluate if time to thrombolytic therapy can be used as a predictor of mortality in patients receiving intravenous thrombolysis for severe acute PE

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