Abstract
BackgroundPulmonary embolism (PE) is a common life-threatening condition with non-specific clinical presentations. The diagnosis of PE depends highly on imaging studies, which may also provide prognostic information. This study aimed to describe the clinical and imaging profiles of patients with PE, emphasizing the differences between central and peripheral PE.MethodsAfter ethics review board approval, this retrospective observational study examined the non-negative results in adult patients who underwent computed tomography pulmonary angiography (CT-PA) at our hospital between May 2016 and December 2019. Demographic and clinical information and imaging findings were collected from the electronic medical records.ResultsThe study included 85 cases that were identified after re-interpreting the 103 non-negative CT-PA scans. Six cases were excluded for incomplete data and 12 cases were false-positive. Central PE was found in 63.5% of the cases. Obesity was the most common risk factor seen in 37.6% of the cases. Furthermore, 9.4% of the patients had sickle cell disease, which tended to be associated with peripheral PE. There was no difference between the peripheral and central PE in most clinical and imaging parameters evaluated (P > 0.05). However, patients with isolated subsegmental PE were more likely to develop hemoptysis (P = 0.04).ConclusionThis study suggests that patients with obesity and sickle cell disease constitute an important proportion of all PE cases. Furthermore, the clinical and imaging profiles in patients with peripheral PE are similar to those in patients with central PE. Future research should focus on the clinical value of peripheral PE in patients with sickle cell disease.
Highlights
Pulmonary embolism (PE) is a common life-threatening condition with non-specific clinical presentations
We aimed to investigate whether there is any difference between the profiles of central and peripheral PE
Patient characteristics The study involved 103 computed tomography pulmonary angiography (CT-PA) scans with PE diagnosis according to the radiology reports
Summary
Pulmonary embolism (PE) is a common life-threatening condition with non-specific clinical presentations. The diagnosis of PE depends highly on imaging studies, which may provide prognostic information. This study aimed to describe the clinical and imaging profiles of patients with PE, emphasizing the differences between central and peripheral PE. Sex, comorbidities, risk factors, and clinical setting (ED vs hospitalized patient) were collected. The assessed risk factors included immobilization, recent surgery or trauma, presence of a previous venous thromboembolic disease, smoking status, obesity, sickle cell disease, use of a central venous catheter, exogenous estrogen use, and a previously existing malignancy. The clinical severity of PE was assessed using the Pulmonary Embolism Severity Index (PESI) [8], which is the most validated prognostic tool for PE [9]
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