Abstract
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.
- © 2011 ERS
