|ECR 2018 / C-0890||
|Assessment of severity and prognosis in patients with pulmonary embolism attending to clot load score on MDCT pulmonary angiography|
Aims and objectives
Despite advances in prophylaxis, diagnostic modalities or therapeutic options in acute pulmonary embolism (PE), 8% - 15% mortality rate is still reported in hemodynamically stable patients, which increases up to 50% - 58% in patients with hemodynamic instability (1, 2). Other series have reported mortality rates from 2% in patients with nonmassive embolus to a 95% in patients with cardiorespiratory arrest (3, 4). As many of those deaths frequently occur within the first hours after admission, a rapid and specific diagnosis is still required (5).
Thus, risk stratification for patients with acute PE is important to establish appropriate treatment and management (6). Current risk prediction rules for patients with acute PE have been mainly based on clinical and laboratory parameters (7, 8).
Among the commonly used clinical imaging modalities, multidetector computed tomography (MDCT) of pulmonary arteries has been established as the main imaging method for diagnosis of acute PE (9-11). But also MDCT of pulmonary arteries allows more comprehensive assessment of the clot burden and signs of right ventricular (RV) dysfunction than echocardiography, as well as additional information of the underlying lung parenchimal disease (12,13).
In the literature, several studies have addressed the role of MDCT pulmonary angiographic parameters for helping predict intermediate and long-term prognosis in patients with acute PE (14-20).
In base of this, the purpose of this work is to determine whether quantification of clot burden in pulmonary arteries can be considered a useful method for predicting a poor prognosis (short and long term mortality or cardiopulmonary complications), based on the MDCT pulmonary angiographic findings from acute PE-hospitalized patients, and to compare our results with those reported in the literature.
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