Real-world characteristics and outcomes of patients with intermediate high risk acute pulmonary embolism
Authors:   Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., J.C Overgaauw Audrey , J Meijboom Lilian ,   Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., van Es Josien ,   Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands., J. Lust Erik ,   Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., H. Serne Erik ,   Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., Nanayakkara P.W.B ,   Section General & Acute Internal Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, M. Smulders Yvo ,   Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., J. Kooter Albertus ,   Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., W. Sprengers Ralf ,   Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., de Grooth Harm-Jan ,   Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., J. Lely Rutger ,   Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., Thijs Abel ,   Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., Vonk Noordegraaf Anton ,   Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands., M.A. Heunks Leo ,   Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., W.G. Elbers Paul ,   Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., Bogaard Harm-Jan ,   Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands., R. Tuinman Pieter ,   Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Cardiovascular Sciences, The Netherlands., J. Nossent Esther ,   Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands.
Published: June 2023

Background: Exact benefits of currently recommended close monitoring in intermediate high risk acute pulmonary embolism (PE) patients are unknown. Methods: This prospective observational cohort study determined clinical characteristics, and disease course of intermediate high risk acute PE patients in an academic hospital setting. Frequency of hemodynamic deterioration, use of rescue reperfusion therapy and PE related mortality, were outcomes of interest. Results: Of 98 intermediate high risk PE patients included for analysis, 81 patients (83%) were closely monitored. Two deteriorated hemodynamically and were treated with rescue reperfusion therapy. One patient survived after this. Conclusions: In these 98 intermediate high risk PE patients, hemodynamic deterioration occurred in three patients and rescue reperfusion therapy of two closely monitored patients led to survival of one. Underlining the need for better recognition of patients benefitting from and research in the optimal way of close monitoring.