Læknablaðið - 15.01.2013, Blaðsíða 15

RANNSÓKN
í sjúkraskrár má auðveldlega sannreyna dánartíðni þeirra sem
skráðir voru.
Helsta viðfangsefni framtíðarinnar snýr að forvörnum gegn
bláæðasegum og lungnasegareki meðal áhættusjúklinga. Þar er
enn verk að vinna. I ljósi sterkra vísbendinga um „ofgreiningu"
á litlum segum í lungnablóðrásinni sem ekki hafa klíníska þýð-
ingu8 samfara vangreiningu á jafnvel stórum segum, er það mikil-
vægt vandamál hvernig unnt er að finna þá sjúklinga sem eru í
áhættu að fá nýtt lungnasegarek13, sem er hættulegt stig í fram-
vindu þessa sjúkdóms.
Á þriggja ára tímabili greindist lungnasegarek í 5 af hverjum
1000 sjúklingum sem lögðust inn á Landspítala. Dánarhlutfall var
hins vegar svipað og í mörgum erlendum rannsóknum, um 10%
fyrstu 30 dagana eftir innlögn. Þótt dánartíðnin hafi snarlækkað
síðustu 40 ár er hún enn há og undirstrikar annars vegar hversu
alvarlegur sjúkdómur lungnarek er og hins vegar hve undirliggj-
andi sjúkdómar eru oft alvarlegir.
Þakkir fá Eysteinn Pétursson, Jóhannes Björnsson, Rósa Mýrdal
og Friðrik Snæbjörnsson fyrir veitta aðstoð.
Heimildir
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ENGLISH SUNIMARY
Pulmonary embolism at Landspítali, The National University Hospital of lceland 2005-2007
- Incidence, clinical manifestations, risk factors and outcome
Jonsson KO12, Agnarsson UTh2, Danielsen R2, Thorgeirsson G12
Introduction: Pulmonary embolism is a serious disease and common
among hospitalized patients. The incidence of pulmonary embolism in
lceland is largely unknown. The purpose of this study was to evaluate
the incidence, clinical presentation, risk factors and outcome among
patients diagnosed with pulmonary embolism at Landspítali, The Natio-
nal University Hospital of lceland.
Material and methods: A retrospective analysis of medical records of
patients diagnosed with the ICD-10 diagnosis I26 (Pulmonary embolism)
between 2005-2007 was carried out. Data were retrieved on age, clinical
manifestations, treatment, risk factors, diagnostic procedures and
outcome.
Results: The total number of patients was 312 and the in-hospital
incidence was 5 per 1.000. Thirty day mortality was 9.9% (95% Cl 6.6-
13.3). Dyspnea was the most common symptom (81%) and diagnosis
was most often established by computed tomography of the pulmonary
vasculature (88,8%). Anticoagulation was by far the most common
management (96%) but thrombolysis, thrombectomy or use of inferior
vena cava filters were very rare. The frequency of atrial fibrillation was
significantly higher in patients with pulmonary hypertension by echocar-
diography than without, 32.4% and 9.7%, respectively (p= 0.026). Thirty
day mortality was significantly higher in women than in men (13.2%
versus 6.5%, p=0.049), and in patients with no classic symptoms of
pulmonary embolism at diagnosis (36.4% versus 8.1%, p=0.012).
Discussion: The hospital incidence of pulmonary embolism, 5/1000
patients, at Landspítali The National University Hospital of lceland is
higher than found in similar studies in many other countries. Mortality,
while similar, has fallen markedly during the past 40 years.
Key words; Pulmonary embolism, deep vein thrombosis, incidence, risk factors, mortality.
Correspondence: Uggi Þ. Agnarsson, uggitha@landspitali.is
University of lceland', Landspítali, The National University Hospital of lceland, Department of Cardiology2
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