Pulmonary embolism: epidemiological data and diagnosis in Kinshasa hospitals

Int J Tuberc Lung Dis. 2017 Aug 1;21(8):875-879. doi: 10.5588/ijtld.16.0418.

Abstract

Background: Pulmonary embolism (PE) is common but difficult to diagnose.

Objective: To describe the epidemiological, clinical and paraclinical characteristics of PE in Kinshasa hospitals.

Method: This was a retrospective study in 158 cases with suspected PE.

Results: The prevalence of PE was 37% among cases with suspicion of the disease. Male sex was predominant (55%). The mean age was 55 ± 15 years. The main risk factors were obesity (53%), immobilisation (43%) and surgery (14%). The main symptoms were dyspnoea (98%), cough (59%), chest pain (43%) and unilateral limb pain (36%). Tachypnoea (88%), tachycardia (53%) and signs of deep-vein thrombosis (36%) were the main clinical presentations. Lung examination was normal in 55% of the patients. PE prevalence in the 'PE likely' category based on the Wells score was 53%. Levels of D-dimers were elevated in all patients. Sinus tachycardia (72%), S1Q3T3 pattern (30%) and T-wave inversion in V1-V4 (34%) were the main electrocardiographic abnormalities. Chest X-ray was normal in 30% of patients. Right ventricular pressure overload was detected in 58% of patients who had access to echocardiography. Computed tomography pulmonary angiography was performed in 65% of patients. All patients were treated with anticoagulants; no cases received thrombolytics. Patients who died (7%) were all in class III-V according to the Pulmonary Embolism Severity Index prognostic score.

Conclusion: PE is common in Kinshasa, with characteristics similar to those reported in the literature.

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / administration & dosage*
  • Chest Pain / epidemiology
  • Chest Pain / etiology*
  • Computed Tomography Angiography / methods
  • Cough / epidemiology
  • Cough / etiology
  • Democratic Republic of the Congo / epidemiology
  • Dyspnea / epidemiology
  • Dyspnea / etiology*
  • Echocardiography
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / epidemiology*
  • Pulmonary Embolism / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index

Substances

  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D