Prognosis of patients with pulmonary embolism after rehabilitation

Mroawan Amoury,1 Frank Noack,1,2 Kathleen Kleeberg,3 Dietrich Stoevesandt,4 Burghart Lehnigk,5 Steffi Bethge,5 Viktoria Heinze,5 Axel Schlitt3,5 1Department of Emergency Medicine, University Clinic Halle-Saale, Halle, Germany; 2Department of Medicine I, University Clinic Halle-Saale, Halle, Germany; 3Medical Faculty, Martin Luther-University Halle-Wittenberg, Halle, Germany; 4Department of Diagnostic Radiology, University Clinic Halle-Saale, Halle, Germany; 5Department of Cardiology and Pulmology, Paracelsus-Harz Clinic Bad Suderode, Quedlinburg, Germany Introduction: Pulmonary embolism (PE) is a life-threatening disease; in Germany, therefore, rehabilitation after PE is recommended in patients with intermediate- and high-risk PE. However, no prospective data on PE after inpatient rehabilitation have been published so far. Patients and methods: For this monocentric study, 70 patients with PE were prospectively recruited between November 2013 and November 2014 after giving written informed consent. This study was approved by the ethics committee of the Medical Association of Saxony-Anhalt. Inclusion criteria were as follows: age ≥18 years and a stay at the Paracelsus-Harz Clinic in Bad Suderode, Germany, with the main indication of PE. During the hospital stay, history-relevant medical data and diagnostic findings were collected and documented. Furthermore, we recorded whether patients were rehospitalized or died during the treatment period in the rehabilitation clinic or during the 12-month follow-up. Results: The mean age was 64.5 ± 13.0 years, the mean body mass index (BMI) was 30.4 ± 6.0 kg/m2, and 54.3% were women. During rehabilitation, two patients (3.9%) were transferred to a primary care hospital; no patient died. However, four patients died (5.7%) in the 12-month follow-up period. A total of 20 patients were hospitalized in the 12-month follow-up period (hospitalization rate during the 12-month follow-up period: 28.6%). Of these 20 patients, one patient was rehospitalized with a newly diagnosed PE (1.4%) and two patients were rehospitalized for bleeding events (2.8%). Conclusion: PE is a life-threatening disease, and therefore it seems reasonable to recommend rehabilitation at least in patients with an intermediate- or high-risk PE. In this study, death and other serious event rates were low during the in-hospital rehabilitation and in the 12-month follow-up period, which underlined the safety and importance of a standardized rehabilitation program after survived PE. Keywords: pulmonary embolism, rehabilitation, prognosis