Helical CT pulmonary angiography predictors of in-hospital morbidity and mortality in patients with acute pulmonary embolism.
J Thorac Imaging
; 18(4): 207-16, 2003 Oct.
Article
en En
| MEDLINE
| ID: mdl-14561905
ABSTRACT
PURPOSE:
To determine if CT variables predict in-hospital morbidity and mortality in patients with pulmonary embolism (PE). MATERIALS ANDMETHODS:
CT scans and charts of 173 patients with CT scans positive for PE were reviewed. CT scans were reviewed for leftward ventricular septal bowing, increased right ventricle (RV) to left ventricle (LV) diameter ratio, clot burden, increased pulmonary artery to aorta diameter ratio, and oligemia. Charts were reviewed for severe morbidity and mortalityoutcomes:
death from pulmonary emboli or any cause, and cardiac arrest. Charts were also reviewed for milder morbidityoutcomes:
intubation, vasopressor use, or admission to an intensive care unit (ICU) and for multiple comorbidities.RESULTS:
No CT predictor was significantly associated with severe morbidity or mortality outcomes. Ventricular septal bowing and increased RV/LV diameter ratio were both associated with subsequent admission to an ICU (P = 0.004 and P = 0.025, respectively). Oligemia (either lung) was associated with subsequent intubation; right lung oligemia was associated with the subsequent use of vasopressors. After controlling for history of congestive heart failure, ischemic heart disease, and pulmonary disease, both septal bowing and an increased RV/LV diameter ratio remained associated with admission to an ICU.CONCLUSION:
No CT variables predicted severe in-hospital morbidity and mortality (death from pulmonary embolism, death from any cause, or cardiac arrest) in patients with PE. However, ventricular septal bowing and increased RV/LV diameter ratio were both strongly predictive of less severe morbidity, namely, subsequent ICU admission, and oligemia was associated with subsequent intubation and vasopressor use.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_other_respiratory_diseases
/
6_venous_thromboembolic_disease
Asunto principal:
Embolia Pulmonar
/
Tomografía Computarizada Espiral
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Thorac Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2003
Tipo del documento:
Article
País de afiliación:
Estados Unidos