Helical CT Pulmonary Angiography Predictors of In-Hospital Morbidity and Mortality in Patients With Acute Pulmonary Embolism

Philip A. Araoz, Michael B. Gotway, Robert L. Trowbridge, Richard A. Bailey, Andrew D. Auerbach, Gautham P. Reddy, Samuel K. Dawn, W. Richard Webb, Charles B. Higgins

Research output: Contribution to journalReview article

139 Scopus citations

Abstract

Purpose: To determine if CT variables predict in-hospital morbidity and mortality in patients with pulmonary embolism (PE). Materials and Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)207-216
Number of pages10
JournalJournal of Thoracic Imaging
Volume18
Issue number4
DOIs
StatePublished - Oct 1 2003

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

Fingerprint Dive into the research topics of 'Helical CT Pulmonary Angiography Predictors of In-Hospital Morbidity and Mortality in Patients With Acute Pulmonary Embolism'. Together they form a unique fingerprint.

  • Cite this