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Contemporary Management of Patients with PE

Am J Med; ePub 2018 Aug 10; Secemsky, et al

Mortality remains substantial among patients with massive and submassive pulmonary embolism (PE); however advanced therapies were independently associated with lower mortality in this cohort. Researchers analyzed a prospective database of patients with massive and submassive PE and reported on clinical characteristics, therapies, and outcomes stratified by PE type. Treatment escalation beyond systemic anticoagulation was defined as advanced therapy. They found:

  • Among 338 patients (average age 63 ±15 years, 50% females, 32.0% had malignancy), 46 (13.6%) presented with massive and 292 (86.4%) with submassive PE.
  • Massive PE patients received advanced therapy in 71.7% and had greater 90-day mortality rates vs submassive PE patients (41.3% vs 12.3%, respectively).
  • Most massive PE deaths occurred in-hospital; whereas mortality risk persisted after discharge for submassive PE.
  • Advanced therapies among all PE patients were associated with a 61% reduction in mortality.


Secemsky E, Chang Y, Jain CC, et al. Contemporary management and outcomes of patients with massive and submassive pulmonary embolism. [Published online ahead of print August 10, 2018]. Am J Med. doi:10.1016/j.amjmed.2018.07.035.