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The effect of supplemental oxygen therapy in patients with intermediate-risk pulmonary embolism (PE) who do not have hypoxemia at baseline is uncertain.

Statins possess antithrombotic and profibrinolytic properties. The association between statin use and short‐term outcomes in patients with acute pulmonary embolism (PE) remains unknown. We used the data from the Registro Informatizado de Pacientes con Enfermedad TromboEmbólica registry to compare the 30‐day all‐cause mortality in patients with acute PE according to the use of statins. Secondary outcome was fatal PE. We used cancer‐related mortality as a falsification endpoint. From January 2009 to April 2021, 31 169 patients with PE were recruited. Of these, 5520 (18%) were using statins at baseline: low intensity: 829, moderate: 3636, high intensity: 1055. Statin users were older and had a higher frequency of diabetes, hypertension, or atherosclerotic disease than non‐users (P<0.001 for all comparisons). During the first 30 days, 1475 patients died (fatal PE, 255). On multivariable analysis, statin users had a lower risk of all‐cause death (odds ratio [OR]: 0.65; 95% confidence interval [CI]: 0.56–0.76) and fatal PE (OR: 0.42; 95% CI: 0.28–0.62) than non‐users. The risk for death was lower in patients using either low‐ (OR: 0.51; 95% CI: 0.34–0.77), moderate‐ (OR: 0.68; 95% CI: 0.57–0.81), or high‐intensity statins (OR: 0.68; 95% CI: 0.51–0.92). Results did not change in mixed effects logistic regression models with hospitals as a random effect. Statins were not associated with a significant chance in cancer mortality (falsification endpoint). PE patients using statins at baseline had a significantly lower risk of dying within the first 30 days than non‐users. Randomized trials are needed to confirm these data.

Statins possess antithrombotic and profibrinolytic properties. The association between statin use and short‐term outcomes in patients with acute pulmonary embolism (PE) remains unknown.

Controversy exists regarding the usefulness of troponin testing for the risk stratification of patients with acute pulmonary embolism (PE). We conducted an updated systematic review and a metaanalysis of troponin-based risk stratification of normotensive patients with acute symptomatic PE. The sources of our data were publications listed in Medline and Embase from 1980 through April 2008 and a review of cited references in those publications.

ObjectivesTo evaluate the association between experience in the management of acute pulmonary embolism, reflected by hospital case volume, and mortality.DesignMultinational population based cohort study using data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry between 1 January 2001 and 31 August 2018.Setting353 hospitals in 16 countries.Participants39 257 consecutive patients with confirmed diagnosis of acute symptomatic pulmonary embolism.Main outcome measurePulmonary embolism related mortality within 30 days after diagnosis of the condition.ResultsPatients with acute symptomatic pulmonary embolism admitted to high volume hospitals (>40 pulmonary embolisms per year) had a higher burden of comorbidities. A significant inverse association was seen between annual hospital volume and pulmonary embolism related mortality. Admission to hospitals in the highest quarter (that is, >40 pulmonary embolisms per year) was associated with a 44% reduction in the adjusted odds of pulmonary embolism related mortality at 30 days compared with admission to hospitals in the lowest quarter (<15 pulmonary embolisms per year; adjusted risk 1.3% v2.3%; adjusted odds ratio 0.56 (95% confidence interval 0.33 to 0.95); P=0.03). Results were consistent in all sensitivity analyses. All cause mortality at 30 days was not significantly reduced between the two quarters (adjusted odds ratio 0.78 (0.50 to 1.22); P=0.28). Survivors showed little change in the odds of recurrent venous thromboembolism (odds ratio 0.76 (0.49 to 1.19)) or major bleeding (1.07 (0.77 to 1.47)) between the low and high volume hospitals.ConclusionsIn patients with acute symptomatic pulmonary embolism, admission to high volume hospitals was associated with significant reductions in adjusted pulmonary embolism related mortality at 30 days. These findings could have implications for management strategies.