Different manifestations of pulmonary embolism in younger compared to older patients: Clinical presentation, prediction rules and long-term outcomes

Purpose: Data concerning specific manifestations of pulmonary embolism (PE) among younger patients are scarce. We aimed to evaluate differences in clinical presentation, PE prediction rules, thrombolytic treatment use and PE outcomes in younger (<50 years of age) compared to older patients. Material/methods: We studied 238 consecutive patients with proven PE who were retrospectively categorized into three PE probability subgroups according to the revised Geneva score (RGS) and Wells score (WS). Duration of follow-up was up to 115 months. Results: Younger patients accounted for 19.7% of the study cohort. Obesity and smoking were significantly more common, while comorbidities were less common (P < 0.05) in the younger patients. According to RGS and WS, younger patients were more often categorized into the low PE probability subgroup and rarely into the high probability subgroup (P < 0.05). We found no differences in clinical signs, symptoms, and treatment between the two groups. In-hospital (2% vs. 13%) and long-term (12% vs. 36%) mortality rates were significantly lower in younger patients (P = 0.003). Conclusions: In younger PE patients, despite differences in predisposing factors and PE probability grading as assessed by RGS and WS, clinical features at admission and treatment were similar compared to the older group. Our findings confirmed lower mortality among younger compared to older patients. (C) 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.