title: Computed Tomographic Pulmonary Angiographic Findings Can Predict Short-Term Mortality of Saddle Pulmonary Embolism: A Retrospective Multicenter Study.
abstract: OBJECTIVE
  In patients with saddle pulmonary embolism (PE), the correlation between computed tomographic pulmonary angiographic (CTPA) findings and short-term outcome remains unclear. The purpose is to determine if CTPA findings predict 1-month mortality of patients with saddle PE.
  
  
  METHODS
  This is a multicenter, retrospective study of saddle PE. Computed tomographic pulmonary angiographic findings of 115 consecutive patients (male-to-female ratio, 65:50; mean age, 64.3 ± 16.3 years) with saddle PE were evaluated. One-month mortality after diagnosis was the primary end point.
  
  
  RESULTS
  Twenty-four patients died within 1 month. Among CTPA findings, quantitative parameters including right/left ventricular area ratios (RVa/LVa), right/left atrial diameter ratios, Cobb angle, and Mastora score were significantly enlarged in survivors. Also, qualitative findings including contrast agent reflux into the azygos vein and pericardial effusion were significantly different between survivors and nonsurvivors. Areas under the curve on receiver operating characteristic curves revealed the cutoff values for predicting early mortality of saddle PE using right/left atrial diameter ratios, RVa/LVa, Mastora score, and Cobb angle, respectively, were 2.15, 2.00, 69%, and 58°. Logistic regression analysis suggested that both RVa/LVa (odds ratio, 5.100; P = 0.0004) and Cobb angle (odds ratio, 1.596; P = 0.0321) were independent predictors of early mortality. The combination of RVa/LVa and Cobb angle increased the area under the curve to 0.882, but the difference did not reach significance compared with RVa/LVa or Cobb angle, alone (P > 0.05).
  
  
  CONCLUSIONS
  In patients with saddle PE, RVa/LVa and Cobb angle seem valuable in predicting short-term mortality.
authors.affiliation: From the *Department of Radiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing; †Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan; ‡Department of Radiology, China Rehabilitation Research Center of Capital Medical University, Beijing; §Department of Radiology, Beijing Pu Ren Hospital, Beijing; ∥Department of Radiology, First Affiliated Hospital of Medical College of Xi'an JiaoTong University, Xi'an Shannxi; and ¶Respiratory Diseases Research Center, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Guo
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Hongxia
authors.initials: H
authors.lastname: Zhang
authors.forename: Qing
authors.initials: Q
authors.lastname: Hou
authors.forename: Youmin
authors.initials: Y
authors.lastname: Guo
authors.forename: Yuanhua
authors.initials: Y
authors.lastname: Yang
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
mesh_terms: D002681:China / Q000453:epidemiology; D000072226:Computed Tomography Angiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015588:Observer Variation; D015995:Prevalence; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000401:mortality*; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis