Version 1
: Received: 17 May 2023 / Approved: 18 May 2023 / Online: 18 May 2023 (07:44:33 CEST)
How to cite:
Chijik, A.; Zerdev, M.; Daud, W.A.; Sela, Y.; Blum, A. The Ability to Predict Death in Patients with Acute PE. Preprints2023, 2023051291. https://doi.org/10.20944/preprints202305.1291.v1
Chijik, A.; Zerdev, M.; Daud, W.A.; Sela, Y.; Blum, A. The Ability to Predict Death in Patients with Acute PE. Preprints 2023, 2023051291. https://doi.org/10.20944/preprints202305.1291.v1
Chijik, A.; Zerdev, M.; Daud, W.A.; Sela, Y.; Blum, A. The Ability to Predict Death in Patients with Acute PE. Preprints2023, 2023051291. https://doi.org/10.20944/preprints202305.1291.v1
APA Style
Chijik, A., Zerdev, M., Daud, W.A., Sela, Y., & Blum, A. (2023). The Ability to Predict Death in Patients with Acute PE. Preprints. https://doi.org/10.20944/preprints202305.1291.v1
Chicago/Turabian Style
Chijik, A., Yaron Sela and Arnon Blum. 2023 "The Ability to Predict Death in Patients with Acute PE" Preprints. https://doi.org/10.20944/preprints202305.1291.v1
Abstract
Background: Pulmonary emboli (PE) is a life threatening condition that is discovered in many patients only "post mortem". Adequate and timely detection of PE is crucial, because of the high mortality and morbidity and the sudden unexpected hemodynamic collapse that may occur in patients with PE.
Objectives: To assess the ability to predict clinical outcome of patients with acute PE, using a non-gated computed tomography pulmonary angiography (CTPA), based on the dimensions of the right ventricle.
Methods: A retrospective study that analyzed CTPA images of patients admitted with acute PE during the years 2012-2017 in Baruch Padeh Medical Center. The cohort study included 300 patients with documented acute PE, among them 255 were hospitalized in medical (non-intensive care unit) wards, and 45 were patients were hospitalized in an intensive care unit (ICU).
Results: Among the 45 patients admitted to the ICU, 8% died. Larger RV diameters predicted mortality (OR=10.14, 95% CI [1.09-93.86]) as well as lower systolic and diastolic blood pressure measurements (p=0.001 and 0.01).
Among the 255 patients that were admitted in the Internal Medicine Ward 7% died. Older age (p=0.028), sepsis and cancer (both p<0.001), high WBCs count (p<0.001), and renal failure (p<0.001) predicted death.
Overall, of all 300 patients that were admitted, lower blood pressure (systolic and diastolic) (p<0.001, 0.008), older age (p<0.007), sepsis (p<0.001), cancer (p=0.006), higher WBCs count (p<0.001), and impaired renal function (p<0.001) predicted death among patients admitted with confirmed acute PE.
Conclusions: Clinical parameters and hematological parameters could predict the outcome of patients admitted with acute PE. RV diameter, measured by the non-ECG gated CTPA had an additive predictive value for patients who were hemodynamically unstable on admission and were hospitalized in the ICU.
Keywords
Pulmonary emboli; PE; right ventricular (RV) dysfunction
Subject
Medicine and Pharmacology, Emergency Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
