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BIBTEX RIS

Prognostic value of computed tomographic pulmonary angiography and the pulmonary embolism severity index in patients with acute pulmonary embolism

2012; Lippincott Williams & Wilkins; Volume: 24; Issue: 1 Linguagem: Inglês

10.1097/mbc.0b013e32835a72c2

1473-5733

Thiago Horta Soares, Marcos de Bastos, Bruna Vilaça de Carvalho, Wanderval Moreira, Cristiane Pena Cabral, Luciano Fagundes de Paula, Camila Caram‐Deelder, Suely Meireles Rezende,

Radiation Dose and Imaging

Pulmonary embolism is a serious and potentially fatal disorder. Pulmonary embolism risk stratification may allow early hospital discharge and outpatient treatment for low-risk patients. Also, it may prevent death by early medical intervention in high-risk groups. We evaluated objectively confirmed pulmonary embolism in 126 patients by multidetector computed tomographic pulmonary angiography at a single center from January 2008 to January 2010. The Pulmonary Severity Embolism Index (PESI), the right ventricle (RV) to left ventricle (LV) diameter (RV/LV) ratio and the vascular obstruction index (VOI) were derived from data extracted from electronic hospital records and image database. A total of six out of 96 patients (6.3%) died during follow-up. There was an association between PESI and mortality (P-value < 0.001 χ2 test). PESI class I–II had a 100% negative predictive value for death in 90 days. No association was found between the RV/LV ratio, the VOI and mortality (P-value > 0.05 χ2 test). Also, no association was found between the RV/LV ratio and the VOI and PESI (P-value > 0.05 χ2 test). PESI is an accurate tool for pulmonary embolism prognostic stratification. It safely discriminates low-risk from high-risk patients regarding death outcome. We were unable to demonstrate an association between image scores and mortality.