Intermediate-risk pulmonary embolism: Aiming to improve patient stratification

Intermediate-risk pulmonary embolism (PE) patients present a therapeutic dilemma. While some are at risk for developing adverse events, possibly requiring escalation therapy, most will have a benign course. Our aim was to define predictors which will identify those patients who will not deteriorate despite the presence of RV involvement. We evaluated 179 consecutive intermediate-risk PE patients (47% males; mean age: 66 ± 16 years), allocating them to those who did and did not need escalation therapy and evaluating the predictors for deterioration. We then formulated a score to distinguish between those who would not require escalation therapy. Twenty-six patients (15%) required escalation therapy which was associated with significantly more episodes of syncope (42% vs. 15%, p = 0.001), higher D-Dimer levels (10,810 ± 19,147 vs. 3816 ± 6255, p