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European Radiology
Published in: European Radiology 1/2015

01-01-2015 | Computed Tomography

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

Authors: Reza Javadrashid, Maryam Mozayan, Mohammad Kazem Tarzamni, Mohammad Reza Ghaffari, Daniel F. Fouladi

Published in: European Radiology | Issue 1/2015

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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.
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Metadata
Title
Spiral computed tomographic pulmonary angiography in patients with acute pulmonary emboli and no pre-existing comorbidity: a prospective prognostic panel study
Authors
Reza Javadrashid
Maryam Mozayan
Mohammad Kazem Tarzamni
Mohammad Reza Ghaffari
Daniel F. Fouladi
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3383-7

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