Table 3.

Implications for clinical geriatric practice

Incidence, prevalence, morbidity and mortality increase steadily with age

PE is the acute cause of death in the elderly that is least suspected by physicians

Comorbidity could influence symptoms and signs

Spectrum of differential diagnosis of PE is wider in elderly patients due to high prevalence of cardio-respiratory diseases in these patients

Higher percentage of elderly patients have high PTP compared with younger patients

Low percentage of elderly patients with suspected PE have nonhigh PTP and negative D-dimer

Specificity of D-Dimer reduces with age

Increased cut-off of D-Dimer could reduce false positives but, unfortunately, could increase false negatives

12-leads electrocardiogram, chest X-ray and echocardiogram could have a lower specificity with respect to younger patients

Hypoxemia and increased alveolar-arterial oxygen gradient have a high sensitivity and low specificity

Respiratory and metabolic acidosis could be more frequent compared with younger patients

Lung scan could be less useful in the elderly for higher percentage of patients with pre-existing pulmonary diseases or abnormal chest X-ray

Single detector and multidetector pulmonary angio-CT seem to be not influenced by age

Pulmonary angiography could be limited in the elderly because of the higher risk of side effects compared with younger patients