Impact of morphologic characteristics of @entity358 in massive XXXX .

@entity1 @entity712 @entity1457 @entity16 @entity1151 @entity358 @entity880 @entity9236 @entity551
STUDY OBJECTIVE: To assess the impact of morphologically different central @entity358 in @entity1 with @entity1151 (MPEs) on short-term outcome. DESIGN: A prospective registry of consecutive @entity1 . SETTING: An 11-bed closed medical ICU at a 860-bed community general hospital @entity1 : Forty-seven @entity1 with @entity551 due to @entity9236 and @entity358 detected by transesophageal echocardiography who were treated with thrombolysis between January 1994 and April 2000. PROCEDURES: @entity1 were divided into two groups according to the following characteristics of the detected thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Right heart catheterization was performed. RESULTS: The incidence of both types of thromboemboli was comparable. Groups 1 and 2 showed no differences in demographic data, risk factors for @entity1151 , length of preceding clinical symptoms, percentage of @entity1 in shock, hemodynamic variables, serum @entity880 levels on hospital admission, and treatment. Seven fatal cases due to @entity1457 and right @entity712 were present in group 2, but none were present in group 1 (7 of 23 @entity1 vs 0 of 24 @entity1 , respectively; p < 0.05). At 12 h, the cardiac index was lower in group 2 than in group 1 (2.6 +/- 1.0 vs 3.1 +/- 0.9 L/min/m(2), respectively; p < 0.05), and the central venous pressure (15.0 +/- 6.2 vs 12.5 +/- 3.7 mm Hg, respectively; p < 0.05) and total pulmonary resistance (12.9 +/- 5.9 vs 8.6 +/- 2.7 mm Hg/L/min/m(2), respectively; p < 0.001) were higher in group 2 compared to group 1. On hospital admission, inclusion in group 2 (p < 0.03; hazard ratio, 9.53; 95% confidence interval [CI], 1.19 to 76.47) and preexisting chronic medical or @entity16 (p < 0.01; hazard ratio, 16.4; 95% CI, 1.97 to 136.3) were independent predictors of 30-day mortality. CONCLUSION: On hospital admission, morphology of the thromboemboli and the presence of pre-existing chronic medical or @entity16 are independent predictors of 30-day mortality. @entity1 with @entity358 have a worse short-term outcome than those with @entity358 .
