Predictors of Clinical Outcome in Acute Pulmonary Embolism: Correlation of CT Pulmonary Angiography with Clinical, Echocardiography and Laboratory Findings

Abstract

The aims of this study were to retrospectively evaluate whether computed tomographic (CT) parameters were predictors of in-hospital mortality within 30 days of CT imaging and to compare CT parameters with clinical, echocardiographic, and laboratory findings in patients with acute pulmonary embolism (PE). A total of 122 patients (61 women, 61 men; mean age, 64 ± 15 years) with CT scans positive for acute PE were reviewed. Two independent readers who were blinded to clinical outcomes scored pulmonary artery obstructions, evaluated cardiovascular measurements, and assessed qualitative findings. Reports of echocardiographic, clinical, and laboratory findings and clinical outcome were reviewed. Results were correlated with patient outcomes using Wilcoxon's rank-sum, χ², and Student's t tests. Logistic regression analyses were performed to determine predictors of patient outcomes. Thirteen patients (11%) died related to PE within 30 days in the hospital. There were significant differences in the ratio of arterial partial pressure of oxygen to inspired fraction of oxygen and in heart rate between survivors and nonsurvivors (P < .05). No CT or echocardiographic predictor was associated with mortality. The ratio of arterial partial pressure of oxygen to inspired fraction of oxygen and heart rate strongly predicted mortality due to PE. Neither CT pulmonary angiographic variables nor echocardiography could successfully predict in-hospital mortality in patients with acute PE.