RT Journal Article
SR Electronic
T1 A radiological grading system for risk stratification of acute pulmonary embolism: A pilot study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2340
VO 38
IS Suppl 55
A1 Anita Jayadev
A1 Karthikan Srikanthan
A1 Urmi Gupta
A1 Arti Mahto
A1 Zaid Dabbagh
A1 Syed Saboor
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2340.abstract
AB Introduction: Currently there is no radiological scoring system for Pulmonary Embolism (PE) and studies suggest such a system may provide risk stratification data.Null hypothesis: Radiological severity grading of PE has no prognostic information.Methods: All CT Pulmonary Angiograms (CTPAs) over a 6month period were analysed and demographic data collected. A radiologist graded all positive CTPAs, into mild, moderate and severe according to agreed criteria. Variables including: troponin; D-Dimer; CRP; length of in-patient stay; mortality data and re-admissions secondary to PE were recorded.Results: 312 CTPAs were performed: 240 were negative (76.9%) and 72 patients had a PE (23.1%). In the PE group, 21 were male (29.2%); 51 female (70.8%) and the average length of in-patient stay was 19 days. This was significantly longer in the moderately/severe group than mild (p=0.01)There is no correlation between RV dimension and severity of PE. D-Dimer and troponin increase with radiological severe PE but is not statistically significant. More patients with radiological severe PE are re-admitted (13.6%) compared with mild/moderate group (5.32%), however samples were insufficient for analysis, as was the mortality data.13.9% of CTPAs had the diagnosis changed or disputed. 60.4% negative CTPAs had no D-Dimer collected, 40.9% had an alternative diagnosis to PE.Conclusions: This study suggests PE affects 2.4x more females than males and radiological severe PE is associated with longer in-patient stay and greater re-admissions. An adequately powered, prospective study of positive CTPAs is needed to further evaluate use of this grading system.