Abstract 13202: CT Imaging and Clinical Risk Factors for Long Term Survival After Pulmonary Embolism
Introduction: Pulmonary embolism (PE) is common and potentially fatal. The prognostic value of computed tomography (CT) imaging findings and clinical factors on long term all cause mortality in patients with PE has not been reported.
Methods: Retrospective review of 1105 CT scans positive for PE from 1/1/1997–12/31/2002. Patients with incomplete records or chronic PE were excluded. CT scans were evaluated for clot burden, ventricular septal bowing, and RV/LV diameter ratio. Charts were reviewed for the date of death or last correspondence, age, sex, comorbid conditions, clinical variables, and treatment at the time of CT (table 1). The end point was all cause mortality. Univariate and multivariate logistic regression analysis was used.
Results: The mean age was 63 years. 580 deaths occurred from all causes, with a mean survival of 6.2 years. For the remaining patients, a mean of 6.5 years transpired between the CT and the last documented correspondence. Higher clot burden score was associated with a very small decrease in all cause mortality (table 2), but was unrelated to ventricular septal bowing and RV/LV diameter ratio. All cause mortality was associated with advanced age, malignancy, congestive heart failure, pulmonary disease, immunocompromise, diabetes, room air oxygen saturation 100bpm, systolic blood pressure <100mmHg, or no treatment.
Discussion: This is the first study to report the prognostic value of both CT imaging and clinical factors on the long term all-cause mortality in patients with PE. The results indicate that CT imaging findings are not predictive of a poor long term survival, whereas certain clinical factors are predictive of decreased long term survival.
- © 2010 by American Heart Association, Inc.