• Cecilia Becattini, Alexander T Cohen, Giancarlo Agnelli, Luke Howard, Borja Castejón, Javier Trujillo-Santos, Manuel Monreal, Arnaud Perrier, Roger D Yusen, and David Jiménez.
• Department of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy.
• Chest. 2016 Jan 1; 149 (1): 192-200.

BackgroundFor patients diagnosed with acute pulmonary embolism (PE), the prognostic significance of concomitant DVT lacks clarity.MethodsWe performed a meta-analysis of studies that enrolled patients with acute PE to assess the prognostic value of concomitant DVT for the primary outcome of 30-day all-cause mortality and the secondary outcome of 90-day PE-related adverse events. We conducted unrestricted searches of PubMed and Embase from 1980 through September 30, 2014, and used the terms "deep vein thrombosis," "pulmonary embolism," and "prognos*." We used a random-effects model to pool study results, Begg rank-correlation method to evaluate for publication bias, and I(2) testing to assess for heterogeneity.ResultsThe meta-analysis included a total of nine studies (10 cohorts, as one study had two cohorts) with 8,859 patients. Of the seven cohorts with 7,868 participants who had PE and provided results on the primary outcome, 4,379 (56%) had concomitant DVT; 272 of 4,379 (6.2%) patients with concomitant DVT died 30 days after the diagnosis of PE compared with 133 of 3,489 (3.8%) without DVT. Concomitant DVT had a significant association with 30-day all-cause mortality in all patients (seven cohorts; OR, 1.9; 95% CI, 1.5-2.4; I(2) = 0%). Concomitant DVT was not significantly associated with 90-day PE-related adverse outcomes (five cohorts; OR, 1.6; 95% CI, 0.8-3.4; I(2) = 75%).ConclusionsIn patients diagnosed with acute symptomatic PE, concomitant DVT was significantly associated with an increased risk of death within 30 days of PE diagnosis.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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