Non-severe pulmonary embolism: prognostic CT findings.
The goal of this study was to retrospectively evaluate CT cardiovascular parameters and pulmonary artery clot load score as predictors of 3-month mortality in patients with clinically non-severe pulmonary embolism (PE). We included 226 CT positive for PE in hemodynamically stable patients (112 women; mean age 67.1 years ± 16.9). CT were independently reviewed by two observers. Results were compared with occurrence of death within 3 months using Cox regression. Twenty-four (10.6%) patients died, for whom 9 were considered to be due to PE. Interobserver agreement was moderate for the shape of interventricular septum (κ = 0.41), and for the ratio between the diameters of right and left ventricle (RV/LV) (κ = 0.76). Observers found no association between interventricular septum shape and death. A RV/LV diameter ratio >1 was predictive of death (OR, 3.83; p < 0.01) only when we also took into account the value of the embolic burden (< 40%). In a multivariate model, CT cardiovascular parameters were not associated with death. Concomitant lower limb DVT and comorbid conditions were important predictors of death. In clinically non-severe PE, a RV/LV diameter ratio >1 is predictive of death when the embolic burden is low (< 40%).
Moroni
Anne-Line
AL
University J Fourrier, Grenoble, France.
Bosson
Jean-Luc
JL
Hohn
Noélie
N
Carpentier
Françoise
F
Pernod
Gilles
G
Ferretti
Gilbert R
GR
D000368:Aged; D015897:Comorbidity; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol