Septal bowing and pulmonary artery diameter on computed tomography pulmonary angiography are associated with short-term outcomes in patients with acute pulmonary embolism

Emergency Radiology
Mads Dam LyhneChristopher Kabrhel

Abstract

Patients with acute pulmonary embolism (PE) can quickly deteriorate and the condition has high mortality due to right ventricular (RV) failure. Immediately available predictors of adverse outcome are of major interest to the treating physician in the acute setting. The purpose of the present study was to evaluate if easily attainable measurements of RV function from the diagnostic computed tomography pulmonary angiography (CTPA) provide information for fast risk stratification in patients with acute PE. We retrospectively evaluated images from CTPA in 261 patients (age median 60 years, 50% females) enrolled in a prospective study. RV and left ventricular (LV) diameters and their ratio, the presence of septal bowing, contrast reflux in the inferior vena cava, and the diameter of the central pulmonary arteries (PA) were measured. The composite outcome was 5-day severe adverse events including death, acute decompensation, or need for emergent treatment. We used Wilcoxon rank sum test and Fischer's exact test to test between groups and multivariate logistic regression for prediction. In multivariate analysis, increased diameter of the main PA (OR = 1.08 per 1 mm increase, p = 0.047) and the presence of septal bowing (OR = 2.23, p =...Continue Reading

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Citations

Apr 5, 2020·International Journal of Emergency Medicine·Azin ShayganfarShadi Ebrahimian
Feb 7, 2021·Seminars in Respiratory and Critical Care Medicine·Georgios A TriantafyllouParth Rali

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