Helical CT Pulmonary Angiography Predictors of In-Hospital Morbidity and Mortality in Patients With Acute Pulmonary Embolism
| Autor: | Robert L. Trowbridge, Philip A. Araoz, Michael B. Gotway, Samuel K. Dawn, Charles B. Higgins, Richard Anthony Bailey, Gautham P. Reddy, W. Richard Webb, Andrew D. Auerbach |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Ventricular Dysfunction Right Comorbidity Pulmonary angiography Humans Medicine Radiology Nuclear Medicine and imaging Hospital Mortality Lung Retrospective Studies medicine.diagnostic_test business.industry Vascular disease Respiratory disease Angiography Retrospective cohort study Middle Aged medicine.disease Pulmonary embolism medicine.anatomical_structure Acute Disease Multivariate Analysis Female Radiology Morbidity Pulmonary Embolism business Tomography Spiral Computed |
| Zdroj: | Journal of Thoracic Imaging. 18:207-216 |
| ISSN: | 0883-5993 |
| DOI: | 10.1097/00005382-200310000-00001 |
| Popis: | To determine if CT variables predict in-hospital morbidity and mortality in patients with pulmonary embolism (PE).CT scans and charts of 173 patients with CT scans positive for PE were reviewed. CT scans were reviewed for leftward ventricular septal bowing, increased right ventricle (RV) to left ventricle (LV) diameter ratio, clot burden, increased pulmonary artery to aorta diameter ratio, and oligemia. Charts were reviewed for severe morbidity and mortality outcomes: death from pulmonary emboli or any cause, and cardiac arrest. Charts were also reviewed for milder morbidity outcomes: intubation, vasopressor use, or admission to an intensive care unit (ICU) and for multiple comorbidities.No CT predictor was significantly associated with severe morbidity or mortality outcomes. Ventricular septal bowing and increased RV/LV diameter ratio were both associated with subsequent admission to an ICU (P = 0.004 and P = 0.025, respectively). Oligemia (either lung) was associated with subsequent intubation; right lung oligemia was associated with the subsequent use of vasopressors. After controlling for history of congestive heart failure, ischemic heart disease, and pulmonary disease, both septal bowing and an increased RV/LV diameter ratio remained associated with admission to an ICU.No CT variables predicted severe in-hospital morbidity and mortality (death from pulmonary embolism, death from any cause, or cardiac arrest) in patients with PE. However, ventricular septal bowing and increased RV/LV diameter ratio were both strongly predictive of less severe morbidity, namely, subsequent ICU admission, and oligemia was associated with subsequent intubation and vasopressor use. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|