CT findings and long-term mortality after pulmonary embolism

Michael F. Morris, Bruce A. Gardner, Michael B. Gotway, Kristine M. Thomsen, W. Scott Harmsen, Philip A. Araoz

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

OBJECTIVE. The utility of CT findings in predicting long-term mortality in patients with acute pulmonary embolism (PE) is unknown. The purpose of this study is to retrospectively determine whether three CT findings-increased embolic burden, interventricular septal bowing toward the left ventricle, and right ventricle-to-left ventricle (RV/LV) diameter ratio greater than 1-are independent predictors of long-term all-cause mortality after acute PE. MATERIALS AND METHODS. A total of 1105 patients (47% female; mean age, 63 ±16 years) with CT scans positive for PE from January 1, 1997, to December 31, 2002, were included. Scans were independently interpreted by two observers, with a third independent observer reviewing discrepant cases. CT findings and clinical information were compared with all-cause mortality using univariate and multivariate logistic regression analyses. RESULTS. The median duration of survival was 6.2 years following acute PE, with estimated 10-year survival of 37.4%. CT-derived embolic burden was associated with a very small decrease in long-term all-cause mortality in both univariate (hazard ratio [HR], 0.97; p < 0.001) and multivariate (HR, 0.97; p < 0.001) analyses. Interventricular septal bowing and RV/LV diameter ratio were not significantly associated with long-term all-cause mortality. CONCLUSION. CT findings are not predictive of decreased long-term survival after acute PE.

Original languageEnglish (US)
Pages (from-to)1346-1352
Number of pages7
JournalAmerican Journal of Roentgenology
Volume198
Issue number6
DOIs
StatePublished - Jun 1 2012

Keywords

  • CT
  • Outcome
  • Pulmonary embolism
  • Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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