Abstract
Aim: Pulmonary embolism is an important cause of mortality and morbidity. We aimed to evaluate the location of CT pulmonary angiography findings in prediction of mortality and cardiac comorbidity.
Method: We appraised the patients diagnosed as pulmonary embolism in emergency department, outpatient clinics, wards or intensive care units. We assessed the localization which was categorized as subsegmental, segmental, lobar, and main branches and we evaluated diameter of pulmonary artery (dPA), diameter of right ventricular (dRV), ratio of right ventricular/ left ventricular, and the presence of vena cava.
Results: Totally 218 patients (M/F: 114/104 mean age: 52,4 years) were included the study. Distribution of embolisms were subegmental in 42(19 %), segmental in 85(39%), lobar in 61 (28%) and main branches in 30(14%)patients. Mortality was higher in group of main branches than all other locations (6/30(20%) vs 12/188(6.4%, respectively, p:0.012). dPAs were 33(25-55)mm in subsegmental, 36(21-69)mm in in segmental, 38(14-58)mm in lobar branch, and 40,5(23-72)mm in main branch embolism (p:0001). dRVs were 26(17-35)mm in subsegmental , 28(20-49)mm in segmental , 29(17-42)mm in lobar, and 31(16-41)mm in main branch embolism(p:0,002). There was a positive correlation between dPA and dRV (r:0,486, p:0,000). Presence of vena cava reflux did not result in statistical significance.
Conclusion: Entity of main branches embolism in CT pulmonary angiography predict high probability of mortality and also cause incline of pulmonary artery and right ventricle diameter. This study emphasizes the importance of CT to predict mortality and morbidity.
- Copyright ©ERS 2015