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Prognostic Value of CT Pulmonary Angiography Parameters Prediction Short Term Outcome in Patients with Acute Pulmonary Embolism

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Document Type : Research Paper

Abstract

 
BACKGROUND:
Risk stratification for patients with acute pulmonary embolism (PE) is important to create applicable treatment and management. Computed tomography pulmonary angiography (CTPA) is the first-line imaging method for assessment of patients PE. The different parameters of this modality can be used as predictors for survival in those patients.
AIMS:
This study aimed to assess the value of some parameters of CTPA as predictors for short-term mortality in patients with acute PE.
PATIENTS AND METHODS:
This is a prospective study which included a total of 30 adult patients with acute PE diagnosed with CTPA. Patients’ demographic and clinical data were recorded.  Patients were followed up for 30 days after first diagnosis, and the survival rate was recorded. The CTPA parameters including the diameter of pulmonary artery (PA), ascending aorta (AO), superior vena cava (SVC) and inferior cava (IVC), right ventricle/ left ventricle diameter ratio, PA/AO ratio, inferior vena cava reflux as well as bowing of interventricular septum and clot burden according to Qanadli score (QS) were analyzed and compared between survivals and non-survivals.
RESULTS:
The 30-day survival rate in the present study was 73.33%. None of included demographic factors was significantly associated with the survival rate, while only the presence of abnormal coagulation,                   as comorbidity, was significantly associated with reduced survival rate. Four CTPA parameters                were found to be significantly decreasing the survival rate. These were RV/LV over 1.2 (OR=19.0, 95%CI= 2.54-141.93), followed by IVC reflux (OR= 10.56, 95%CI=1.61-69.12), PA/AO ratio over 1.0 (OR= 12.6, 95%CI= 1.07- 148.13), and QS over 18 (OR=6.33, 95%CI= 1.0 to 40.07).
CONCLUSION:
CTPA findings that may predict the short term mortality were RV/LV diameter ratio more than 1.2,  the high grades of IVC reflux, PA/AO ratio over 1.0 and QS >18. However, most of these parameters are non-specific for PE.
 

Keywords

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Iraqi Postgraduate Medical Journal
Volume 22, Issue 2
April 2023
Page 122-130
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