Document Detail


Severe pulmonary embolism:pulmonary artery clot load scores and cardiovascular parameters as predictors of mortality.
MedLine Citation:
PMID:  16603659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively evaluate pulmonary artery (PA) clot load scores and computed tomographic (CT) cardiovascular parameters as predictors of mortality in patients with severe pulmonary embolism (PE). MATERIALS AND METHODS: Institutional review board approval was obtained with waiver of informed consent. A total of 82 consecutive patients (42 women, 40 men; mean age+/-standard deviation, 61 years+/-15) were admitted to the intensive care unit for PE-related conditions and were evaluated by using CT pulmonary angiography. Two independent readers who were blinded to clinical outcome quantified PA clot load by using four scoring systems. Cardiovascular measurements included right ventricular (RV) and left ventricular (LV) short-axis measurements; RV short axis to LV short axis (RV/LV) ratios; main PA, ascending aorta, azygos vein, and superior vena cava diameters; and main PA diameter to aorta diameter ratios. Reflux of contrast medium into the inferior vena cava, leftward bowing of the interventricular septum, pleural or pericardial effusion, pulmonary consolidation, infarct, platelike atelectasis, and mosaic ground-glass opacity were also recorded. Results were correlated with patient outcome during hospital stay by using the Wilcoxon rank sum and chi2 tests. RESULTS: Twelve patients died within 1-14 days. RV and LV short axis; RV/LV ratio; azygos vein, superior vena cava, and aorta diameters; and contrast medium reflux into the inferior vena cava were significantly different between survivors and nonsurvivors (P<.05). No significant relationship was found between PA clot load and mortality rate. RV/LV ratio and azygos vein diameter allowed correct prediction of survival in 89% of patients (P<.001). CONCLUSION: RV/LV ratio and azygos vein diameter are predictors of mortality in patients with severe PE.
Authors:
Benoit Ghaye; Alexandre Ghuysen; Valerie Willems; Bernard Lambermont; Paul Gerard; Vincent D'Orio; Pierre Alain Gevenois; Robert F Dondelinger
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Publication Detail:
Type:  Journal Article     Date:  2006-04-07
Journal Detail:
Title:  Radiology     Volume:  239     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-22     Completed Date:  2006-06-08     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  884-91     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) RSNA, 2006.
Affiliation:
Department of Medical Imaging and Medicine, University Hospital of Liege, B35 Sart Tilman, B-4000 Liege, Belgium. bghaye@chu.ulg.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography
Aortography
Azygos Vein / radiography
Cause of Death
Contrast Media
Female
Forecasting
Heart Septum / radiography
Heart Ventricles / radiography
Humans
Male
Middle Aged
Pericardial Effusion / radiography
Pleural Effusion / radiography
Pulmonary Artery / radiography*
Pulmonary Atelectasis / radiography
Pulmonary Embolism / classification,  radiography*
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed*
Vena Cava, Inferior / radiography
Vena Cava, Superior / radiography
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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