From the Guidelines
Pulmonary embolism risk factors include prolonged immobility, recent surgery, trauma, pregnancy and postpartum period, use of estrogen-containing medications, cancer, older age, obesity, and personal or family history of blood clots, as identified in the most recent study 1.
Key Risk Factors
- Prolonged immobility (such as long flights or bed rest)
- Recent surgery (especially orthopedic, pelvic, or abdominal procedures)
- Trauma
- Pregnancy and postpartum period
- Use of estrogen-containing medications (birth control pills or hormone replacement therapy)
- Cancer
- Older age
- Obesity
- Personal or family history of blood clots
Medical Conditions that Increase Risk
- Heart failure
- Inflammatory bowel disease
- Inherited blood clotting disorders like Factor V Leiden mutation
- Smoking, which promotes blood vessel damage and hypercoagulability
Importance of Recognizing Risk Factors
Recognizing personal risk factors is crucial for earlier diagnosis and treatment of pulmonary embolism, which can be life-threatening. Individuals with multiple risk factors have compounded risk and should be especially vigilant about preventive measures such as early mobilization after surgery, compression stockings during long travel, and appropriate anticoagulation when recommended by healthcare providers, as suggested by 1 and 1.
Clinical Prediction Scores
Clinical prediction scores like Wells’ rule and the Revised Geneva score can help assess the likelihood of pulmonary embolism, as outlined in 1. These scores consider factors such as previous PE or DVT, heart rate, surgery or immobilization, haemoptysis, active cancer, and clinical signs of DVT.
Preventive Measures
Preventive measures such as early mobilization after surgery, compression stockings during long travel, and appropriate anticoagulation when recommended by healthcare providers can help reduce the risk of pulmonary embolism, especially in individuals with multiple risk factors, as emphasized by 1 and 1.
From the Research
Risk Factors for Pulmonary Embolism
The risk factors for pulmonary embolism can be grouped into several categories, including:
- Hypercoagulability, which refers to an increased tendency for blood to clot [ 2 ]
- Stasis, which refers to a reduction in blood flow [ 2 ]
- Injury to the blood vessels, which can increase the risk of clotting [ 2 ]
Specific Risk Factors
Some specific risk factors for pulmonary embolism include:
- Inherited thrombophilia, which is a genetic disorder that increases the risk of blood clots [ 2 ]
- Age, with older adults being at higher risk [ 2 ]
- Malignancy, or cancer, which can increase the risk of blood clots [ 2 ]
- Estrogens, which can increase the risk of blood clots in some individuals [ 2 ]
- Pregnancy, which can increase the risk of pulmonary embolism [ 3 ]
- COVID-19, which can increase the risk of pulmonary embolism [ 3 ]
Clinical Presentation and Diagnosis
Pulmonary embolism can be difficult to diagnose, and a healthy index of suspicion is often the key to diagnosis [ 2 ]. Clinical decision rules and risk assessment models can help identify patients at risk for pulmonary embolism and guide diagnostic testing [ 2 ]. Diagnosis is usually confirmed with imaging tests such as compression ultrasound or chest CT [ 4 ].
Management and Treatment
Management of pulmonary embolism requires a multifactorial approach involving risk stratification, determining appropriate diagnostics, and selecting individualized therapy [ 3 ]. Treatment typically involves anticoagulation, and patients with high-risk pulmonary embolism may benefit from advanced treatments such as thrombolysis or embolectomy [ 5 , 6 , 4 ].