PMID: 20625619Jul 14, 2010Paper

Central clot score at computed tomography as a predictor of 30-day mortality after acute pulmonary embolism

Annals of the Academy of Medicine, Singapore
Sudhakar Kundapur Venkatesh, Shih Chang Wang

Abstract

The severity of acute pulmonary embolism can be assessed with computed tomography (CT) using clot burden estimation. We compared the existing CT obstruction scores with an in-house developed central clot score for the prediction of 30-day pulmonary embolism (PE)-related mortality. In 125 consecutive patients [47 men, 78 women; mean age +/- standard deviation (SD, 60.4 years +/- 16.6] with acute PE, 2 readers in consensus assessed the severity of PE with 2 existing clot scoring systems (Mastora and Qanadli) and central clot score. The right ventricular dysfunction was assessed by right ventricular diameter (RVD), left ventricular diameter (LVD), ventricular ratio (VR) and septal deviation. Univariate and multivariate regression analysis were performed to correlate these parameters and 30-day PE-related mortality. Ten patients (8%) died of PE within 30 days following CT and 115 patients did not have PE-related death outcome. There was a significant difference in all 3 clot scores, LVD and VR between patients with 30-day PE-related death and those without (P < or =0.001-0.02). Univariate regression analysis showed that all three clot scores and LVD were predictors of PE death, however with multivariate analysis, only central clot ...Continue Reading

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