title: Spiral computed tomographic pulmonary angiography in patients with acute pulmonary emboli and no pre-existing comorbidity: a prospective prognostic panel study.
abstract: OBJECTIVE
  To investigate the prognostic validity of the right ventricular to left ventricular diameter (RVD/LVD) ratio and Qanadli pulmonary artery obstruction score (PAOS) in hemodynamically stable patients with no pre-existing comorbidities.
  
  
  METHODS
  Sixty-three patients with no previous comorbidity were recruited for this study. The RVD/LVD ratio was calculated based on axial image measurements obtained from contrast-enhanced non-electrocardiography-gated spiral computed tomography (CT) pulmonary angiographic studies. Patients were followed up for 60 days after the initial CT and study variables including demographic data, the RVD/LVD ratio and PAOS were compared between deceased cases and survivors via univariate and multivariate statistical models.
  
  
  RESULTS
  The 60-day mortality rate was 22.2%. The deceased and surviving groups were comparable for PAOS, whereas both the median age and RVD/LVD ratio were significantly higher in the first group. In multivariate analysis, however, age was the only significant, independent predictor of 60-day mortality (p = 0.02, Exp(B) = 1.06). At a cut-off age of 63 years the 60-day mortality was predicted with a sensitivity and specificity of 64.3% and 69.4%, respectively.
  
  
  CONCLUSIONS
  The RVD/LVD ratio and PAOS are not independent predictors of mortality in hemodynamically stable patients with acute PE and no pre-existing comorbidities.
  
  
  CONCLUSIONS
  • Patients with pulmonary embolism and no pre-existing comorbidity were studied. • The PAOS alone cannot predict mortality in these patients. • Right ventricle strain is not an independent prognostic factor for mortality in pulmonary embolism. • Age is the only independent predictor of death in pulmonary embolism.
authors.affiliation: Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Javadrashid
authors.forename: Maryam
authors.initials: M
authors.lastname: Mozayan
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Tarzamni
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ghaffari
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Fouladi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult