Delay in Thrombolysis of Massive and Submassive Pulmonary Embolism

Objective: To report the time of delay in thrombolysis of massive and submassive pulmonary embolism (PE). Methods: We enrolled 83 consecutive patients with massive and submassive PE from 8 hospitals between June 2006 and March 2009. We recorded the delay between symptom onset and thrombolysis. The clinical findings related to early thrombolysis (delay ≤2 days) were analyzed. Results: Median of the delay in thrombolysis was 8 days with 82% over 2 days, 53% over 7 days, and 6% over 25 days. Compared to the late thrombolysis (delay >2 days), patients with early thrombolysis more frequently had murmurs at the tricuspid area (26.7% vs 6.1%, P = .053), less frequently had cough (20% vs 59.7%, P = .005) and increased P2 (pulmonic component of second heart sound; 33.3% vs 61.2%, P = .049), and more patients were thrombolysed in off-hours (86.7% vs 57.4%, P = .034). Conclusion: The time of delay in thrombolysis is too long and the symptoms and signs between early and late thrombolysis groups may differ.