Original Articles
Prognostic Value of Syncope in the Presentation of Pulmonary Embolism
D. Jiméneza,
, G. Díazb, M. Vallea, D. Martíc, C. Escobarc, R. Vidala, J. Pichera, A. Sueiroa
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djc_69_98@yahoo.com
Correspondence: Dr. D. Jiménez Castro. Servicio de Neumología. Hospital Ramón y Cajal. Departamento de Medicina. Universidad de Alcalá de Henares. Ctra. de Colmenar, Km 9,100. 28034 Madrid. España
Correspondence: Dr. D. Jiménez Castro. Servicio de Neumología. Hospital Ramón y Cajal. Departamento de Medicina. Universidad de Alcalá de Henares. Ctra. de Colmenar, Km 9,100. 28034 Madrid. España
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"apellidos" => "Jiménez" "email" => array:1 [ 0 => "djc_69_98@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Díaz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Valle" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "D." "apellidos" => "Martí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 4 => array:3 [ "nombre" => "C." "apellidos" => "Escobar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "R." "apellidos" => "Vidal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 6 => array:3 [ "nombre" => "J." "apellidos" => "Picher" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 7 => array:3 [ "nombre" => "A." "apellidos" => "Sueiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de la Zarzuela, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. D. Jiménez Castro. Servicio de Neumología. Hospital Ramón y Cajal. Departamento de Medicina. Universidad de Alcalá de Henares. Ctra. de Colmenar, Km 9,100. 28034 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-07-08" "fechaAceptado" => "2005-02-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154111" "palabras" => array:4 [ 0 => "Pulmonary embolism" 1 => "Syncope" 2 => "Recurrences" 3 => "Death" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154110" "palabras" => array:4 [ 0 => "Tromboembolia de pulmón" 1 => "Síncope" 2 => "Recurrencia" 3 => "Muerte" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Although the prognostic value of syncope has not been specifically addressed, it has generally been considered an indicator of poor prognosis in pulmonary embolism. The objective of this study was to carry out a prospective evaluation of the risk of recurrence and/or death in patients with pulmonary embolism that presents with syncope.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 168 patients had a confirmed diagnosis of pulmonary embolism. Twelve were lost to follow up and did not enter statistical analysis. The mean follow-up period was 5 months.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of syncope in the patients studied was 22%. Of the 34 patients who presented syncope, objectively confirmed recurrence occurred in 2 (5.9%). In the patients who did not present syncope, recurrence was confirmed in 8 (6.6%; <span class="elsevierStyleItalic">P</span> = .8). Death occurred in 2 patients (5.9%) from the group presenting syncope and 15 (12.3%) from the remaining patients in the series (<span class="elsevierStyleItalic">P</span> = .4). The relative risk of recurrence and/or death associated with presentation of syncope was 0.5 (95% confidence interval, 0.2-1.8). A similar risk was obtained following adjustment for the presence or absence of cancer or deep vein thrombosis.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Patients with pulmonary embolism that presents with syncope do not have an increased risk of recurrence and/or death.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Clásicamente se ha considerado que el síncope es un factor de mal pronóstico en la tromboembolia de pulmón (TEP), aunque esta cuestión no se ha estudiado de forma específica. El objetivo de nuestro estudio ha sido evaluar de forma prospectiva el riesgo de recurrencia y/o muerte en pacientes con síncope como forma de presentación.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudiamos a 168 pacientes con diagnóstico confirmado de TEP durante una media de 5 meses.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de síncope en la serie estudiada fue de un 22%. Entre los 34 pacientes que sufrieron un síncope, se produjo una recurrencia objetivamente confirmada en 2 pacientes (5,9%). En el resto de los pacientes se objetivaron 8 recurrencias (6,6%) (p = 0,8). Se produjeron 2 fallecimientos en el grupo de pacientes con síncope (5,9%) y 15 (12,3%) en el resto de la serie (p = 0,4). El riesgo relativo de recurrencia y/o muerte asociado al síncope fue de 0,5 (intervalo de confianza del 95%, 0,2-1,8). El riesgo fue similar despuÉs de ajustarlo a la presencia o ausencia de cáncer o de trombosis venosa profunda.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los pacientes con síncope como forma de presentación de la TEP no tienen un riesgo aumentado de recurrencia y/o muerte respecto al resto.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 1 | 5 |
| 2024 October | 28 | 18 | 46 |
| 2024 September | 23 | 13 | 36 |
| 2024 August | 38 | 38 | 76 |
| 2024 July | 22 | 21 | 43 |
| 2024 June | 34 | 27 | 61 |
| 2024 May | 33 | 30 | 63 |
| 2024 April | 19 | 25 | 44 |
| 2024 March | 21 | 18 | 39 |
| 2024 February | 16 | 20 | 36 |
| 2023 March | 2 | 6 | 8 |
| 2023 February | 14 | 16 | 30 |
| 2023 January | 17 | 45 | 62 |
| 2022 December | 22 | 34 | 56 |
| 2022 November | 17 | 21 | 38 |
| 2022 October | 24 | 33 | 57 |
| 2022 September | 20 | 28 | 48 |
| 2022 August | 14 | 31 | 45 |
| 2022 July | 19 | 36 | 55 |
| 2022 June | 16 | 24 | 40 |
| 2022 May | 18 | 36 | 54 |
| 2022 April | 14 | 32 | 46 |
| 2022 March | 15 | 31 | 46 |
| 2022 February | 17 | 29 | 46 |
| 2022 January | 13 | 29 | 42 |
| 2021 December | 17 | 40 | 57 |
| 2021 November | 16 | 49 | 65 |
| 2021 October | 20 | 32 | 52 |
| 2021 September | 19 | 48 | 67 |
| 2021 August | 9 | 35 | 44 |
| 2021 July | 14 | 27 | 41 |
| 2021 June | 9 | 40 | 49 |
| 2021 May | 24 | 27 | 51 |
| 2021 April | 27 | 54 | 81 |
| 2021 March | 18 | 16 | 34 |
| 2021 February | 11 | 19 | 30 |
| 2021 January | 9 | 8 | 17 |
| 2020 December | 8 | 15 | 23 |
| 2020 November | 15 | 9 | 24 |
| 2020 October | 9 | 12 | 21 |
| 2020 September | 4 | 8 | 12 |
| 2020 August | 10 | 10 | 20 |
| 2020 July | 12 | 20 | 32 |
| 2020 June | 4 | 7 | 11 |
| 2020 May | 13 | 20 | 33 |
| 2020 April | 15 | 19 | 34 |
| 2020 March | 11 | 14 | 25 |
| 2020 February | 13 | 16 | 29 |
| 2020 January | 8 | 17 | 25 |
| 2019 December | 10 | 14 | 24 |
| 2019 November | 15 | 21 | 36 |
| 2019 October | 5 | 8 | 13 |
| 2019 September | 2 | 9 | 11 |
| 2019 August | 10 | 14 | 24 |
| 2019 July | 8 | 14 | 22 |
| 2019 June | 3 | 5 | 8 |
| 2019 May | 11 | 7 | 18 |
| 2019 April | 10 | 11 | 21 |
| 2019 March | 7 | 18 | 25 |
| 2019 February | 7 | 21 | 28 |
| 2019 January | 8 | 9 | 17 |
| 2018 December | 8 | 21 | 29 |
| 2018 November | 22 | 16 | 38 |
| 2018 October | 25 | 14 | 39 |
| 2018 September | 18 | 14 | 32 |
| 2018 May | 1 | 1 | 2 |
| 2018 April | 5 | 7 | 12 |
| 2018 March | 2 | 4 | 6 |
| 2018 February | 4 | 6 | 10 |
| 2018 January | 5 | 11 | 16 |
| 2017 December | 9 | 14 | 23 |
| 2017 November | 7 | 13 | 20 |
| 2017 October | 5 | 17 | 22 |
| 2017 September | 5 | 15 | 20 |
| 2017 August | 7 | 24 | 31 |
| 2017 July | 4 | 13 | 17 |
| 2017 June | 9 | 19 | 28 |
| 2017 May | 5 | 16 | 21 |
| 2017 April | 5 | 8 | 13 |
| 2017 March | 2 | 11 | 13 |
| 2017 February | 3 | 12 | 15 |
| 2017 January | 2 | 5 | 7 |
| 2016 December | 7 | 9 | 16 |
| 2016 November | 11 | 20 | 31 |
| 2016 October | 19 | 10 | 29 |
| 2016 September | 15 | 13 | 28 |
| 2016 August | 15 | 6 | 21 |
| 2016 July | 7 | 5 | 12 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 61 | 1 | 62 |
| 2015 September | 45 | 19 | 64 |
| 2015 August | 48 | 16 | 64 |
| 2015 July | 51 | 16 | 67 |
| 2015 June | 56 | 7 | 63 |
| 2015 May | 51 | 23 | 74 |
| 2015 April | 28 | 13 | 41 |
| 2015 March | 39 | 14 | 53 |
| 2015 February | 33 | 4 | 37 |
| 2015 January | 59 | 8 | 67 |
| 2014 December | 43 | 5 | 48 |
| 2014 November | 51 | 6 | 57 |
| 2014 October | 75 | 13 | 88 |
| 2014 September | 49 | 12 | 61 |
| 2014 August | 57 | 13 | 70 |
| 2014 July | 56 | 9 | 65 |
| 2014 June | 59 | 12 | 71 |
| 2014 May | 77 | 11 | 88 |
| 2014 April | 65 | 5 | 70 |
| 2014 March | 83 | 9 | 92 |
| 2014 February | 57 | 10 | 67 |
| 2014 January | 48 | 7 | 55 |
| 2013 December | 42 | 12 | 54 |
| 2013 November | 45 | 5 | 50 |
| 2013 October | 39 | 9 | 48 |
| 2013 September | 42 | 8 | 50 |
| 2013 August | 44 | 10 | 54 |
| 2013 July | 50 | 16 | 66 |
| 2013 June | 37 | 6 | 43 |
| 2013 May | 31 | 5 | 36 |
| 2013 April | 23 | 6 | 29 |
| 2013 March | 6 | 2 | 8 |
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