CT Pulmonary Angiography for Risk Stratification of Patients with Nonmassive Acute Pulmonary Embolism.

Journal

Radiology. Cardiothoracic imaging
ISSN: 2638-6135
Titre abrégé: Radiol Cardiothorac Imaging
Pays: United States
ID NLM: 101748663

Informations de publication

Date de publication:
Aug 2020
Historique:
received: 13 09 2019
revised: 24 02 2020
accepted: 21 04 2020
entrez: 29 3 2021
pubmed: 30 3 2021
medline: 30 3 2021
Statut: epublish

Résumé

To investigate the prognostic value of an integrative approach combining clinical variables and the Qanadli CT obstruction index (CTOI) in patients with nonmassive acute pulmonary embolism (PE). This retrospective study included 705 consecutive patients (mean age, 63 years; range, 18-95 years) with proven PE. Clot burden was quantified using the CTOI, which reflects the ratio of fully or partially obstructed pulmonary arteries to normal arteries. Patients were subdivided into two groups according to the presence (group A) or absence (group B) of preexisting cardiopulmonary disease. Thirty-day and 3-month mortality was evaluated. CTOI thresholds of 20% and 40% were used to stratify patients regarding outcome (low, intermediate, and high risk). The predictive value of CTOI was assessed through logistic regression analysis. Analysis included 690 patients (mean age, 63.3 years ± 18 [standard deviation]) with complete follow-up data: 247 (36%) in group A and 443 (64%) in group B. The mean CTOI was 23% ± 19, 30-day mortality was 9.7%, and 3-month mortality was 11.6%. Three-month mortality was higher in group A than in group B (17.8% and 8.1%, respectively; CTOI predicted outcome in this cohort of patients with PE and no cardiopulmonary disease, and it may provide a simple single-examination-based approach for risk stratification in this subset of patients.© RSNA, 2020See also the commentary by Kay and Abbara in this issue.

Identifiants

DOI: 10.1148/ryct.2020190188 PMID: 33778598 PMC: PMC7978016
pubmed: 33778598
doi: 10.1148/ryct.2020190188
pmc: PMC7978016
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e190188

Commentaires et corrections

Type : CommentIn

Informations de copyright

2020 by the Radiological Society of North America, Inc.

Déclaration de conflit d'intérêts

Disclosures of Conflicts of Interest: D.C.R. disclosed no relevant relationships. J.F.K. disclosed no relevant relationships. A.M.J. disclosed no relevant relationships. A.G. disclosed no relevant relationships. S.D.Q. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: institution receives payment from BD Bard for consulting. Other relationships: disclosed no relevant relationships.

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Auteurs

David C Rotzinger (DC)

Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology (D.C.R., A.M.J., S.D.Q.) and EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM) and Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology (J.F.K.), Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland (D.C.R., J.F.K., S.D.Q.); and Imagerive Diagnostic Radiology Institute, Geneva, Switzerland (G.A.).
ORCID: 0000-0002-6321-3180

Jean-François Knebel (JF)

Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology (D.C.R., A.M.J., S.D.Q.) and EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM) and Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology (J.F.K.), Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland (D.C.R., J.F.K., S.D.Q.); and Imagerive Diagnostic Radiology Institute, Geneva, Switzerland (G.A.).
ORCID: 0000-0003-1665-1724

Anne-Marie Jouannic (AM)

Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology (D.C.R., A.M.J., S.D.Q.) and EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM) and Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology (J.F.K.), Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland (D.C.R., J.F.K., S.D.Q.); and Imagerive Diagnostic Radiology Institute, Geneva, Switzerland (G.A.).

Ghazal Adler (G)

Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology (D.C.R., A.M.J., S.D.Q.) and EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM) and Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology (J.F.K.), Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland (D.C.R., J.F.K., S.D.Q.); and Imagerive Diagnostic Radiology Institute, Geneva, Switzerland (G.A.).

Salah D Qanadli (SD)

Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology (D.C.R., A.M.J., S.D.Q.) and EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM) and Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology (J.F.K.), Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland (D.C.R., J.F.K., S.D.Q.); and Imagerive Diagnostic Radiology Institute, Geneva, Switzerland (G.A.).

Classifications MeSH