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Eur Radiol. 2015 Jan;25(1):147-54. doi: 10.1007/s00330-014-3383-7. Epub 2014 Aug 28.

Spiral computed tomographic pulmonary angiography in patients with acute pulmonary emboli and no pre-existing comorbidity: a prospective prognostic panel study.

Author information

1
Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

OBJECTIVE:

To investigate the prognostic validity of the right ventricular to left ventricular diameter (RVD/LVD) ratio and Qanadli pulmonary artery obstruction score (PAOS) in hemodynamically stable patients with no pre-existing comorbidities.

METHODS:

Sixty-three patients with no previous comorbidity were recruited for this study. The RVD/LVD ratio was calculated based on axial image measurements obtained from contrast-enhanced non-electrocardiography-gated spiral computed tomography (CT) pulmonary angiographic studies. Patients were followed up for 60 days after the initial CT and study variables including demographic data, the RVD/LVD ratio and PAOS were compared between deceased cases and survivors via univariate and multivariate statistical models.

RESULTS:

The 60-day mortality rate was 22.2%. The deceased and surviving groups were comparable for PAOS, whereas both the median age and RVD/LVD ratio were significantly higher in the first group. In multivariate analysis, however, age was the only significant, independent predictor of 60-day mortality (p = 0.02, Exp(B) = 1.06). At a cut-off age of 63 years the 60-day mortality was predicted with a sensitivity and specificity of 64.3% and 69.4%, respectively.

CONCLUSIONS:

The RVD/LVD ratio and PAOS are not independent predictors of mortality in hemodynamically stable patients with acute PE and no pre-existing comorbidities.

KEY POINTS:

• Patients with pulmonary embolism and no pre-existing comorbidity were studied. • The PAOS alone cannot predict mortality in these patients. • Right ventricle strain is not an independent prognostic factor for mortality in pulmonary embolism. • Age is the only independent predictor of death in pulmonary embolism.

PMID:
25163897
DOI:
10.1007/s00330-014-3383-7
[Indexed for MEDLINE]

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