Clinical and radiological characteristics of acute pulmonary embolus in relation to 28-day and 6-month mortality

Lindsey Norton, Gordon Cooper, Owen Sheerins, Killian Mac a’ Bháird, Giles Roditi, Michael Adamson, David Young, Ross Dolan, Colin Church, Adrian Brady, Campbell Tait, Graham McKenzie, Alasdair McFadyen, Matthew Zelic, Donogh Maguire, Wen-Chi Chou (Editor)

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with acute pulmonary embolism (PE) exhibit a wide spectrum of clinical and laboratory features when presenting to hospital and pathophysiologic mechanisms differentiating low-risk and high-risk PE are poorly understood. Objectives: To investigate the prognostic value of clinical, laboratory and radiological information that is available within routine tests undertaken for patients with acute PE. Methods: Electronic patient records (EPR) of patients who underwent Computed Tomography Pulmonary Angiogram (CTPA) scan for the investigation of acute PE during 6-month period (01.01.2016–30.06.2016) were examined. Data was gathered from EPR for patients that met inclusion criteria and all CTPA scans were re-evaluated. Biochemical thresholds of low-grade and high-grade inflammation, serum CRP >10mg/L and >150mg/L and serum albumin concentrations 100, poGPS≥1, NLR ≥3 and CAC score ≥6 were associated with 28-day and 6-month mortality. PESI score ≥100, poGPS≥1 and NLR ≥3 remained independently associated with 28-day mortality. PESI score ≥100 and CAC score ≥6 remained independently associated with 6-month mortality. When patients with underlying cancer were excluded from the analysis, GPS≥1 remained independently associated with 6-month mortality. The role of the systemic inflammatory response (SIR) in determining treatment and prognosis requires further study. Routine reporting of CAC scores in CTPA scans for acute PE may have a role in aiding clinical decision-making regarding treatment and prognosis.
Original languageEnglish
Article numbere0258843
JournalPLoS ONE
Volume16
Issue number12
DOIs
Publication statusPublished - 28 Dec 2021

Keywords

  • health care
  • medicine and health sciences
  • biology and life sciences
  • pulmonary embolism (PE)
  • patient care
  • Computed Tomography Pulmonary Angiogram (CTPA)

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