J Korean Soc Emerg Med.  2023 Dec;34(6):599-605.

Risk factors and clinical significance of silent pulmonary embolism in patients with deep vein thrombosis

• Lee JH
• Lee JB
• Jin YH
• Jeong TO
• Kim SE
• Oh TH
• Kim SM
• Yoon JC

Abstract

Objective
This study examined the risk factors and clinical significance of silent pulmonary embolism (PE) in patients with deep vein thrombosis (DVT).
Methods
This study was a retrospective observational study using the electronic data of patients with DVT. The study patients were divided into two groups according to the presence of PE. The characteristics of silent PE were reviewed. The baseline characteristics and clinical features were compared between the two groups. Binary logistic regression analysis was then performed using the silent PE as the dependent variable to postulate the independent risk factors for silent PE.
Results
Of the study patients (n=128), 51 patients (39.8%) had silent PE. Four (7.8%) and eight (15.7%) of the silent PE patients, respectively, had right ventricular dysfunction and developed transient PE-related symptoms. Tachycardia (35.3% vs. 19.5%, P=0.045), leg pain (70.6% vs. 50.6%, P=0.025), and DVT (23.5% vs. 6.5%, P=0.005) were higher in the silent PE group than the no PE group. Both DVT (adjusted odds ratio of 3.724; 95% confidence interval, 1.029-13.483) was an independent risk factor for silent PE in logistic regression analysis.
Conclusion
In patients with DVT, approximately 40% of the study patients had silent PE. Although symptomatic PE developed in the silent PE group during hospitalization, additional treatment for symptomatic PE was unnecessary. Both DVT was associated with silent PE.

Keyword

Venous thrombosis; Pulmonary embolism; Venous thromboembolism