From Mayo-Scottsdale: CT scan findings do not predict long-term mortality after pulmonary embolism

http://www.ncbi.nlm.nih.gov/pubmed/22623547

AJR Am J Roentgenol. 2012 Jun;198(6):1346-52.

CT Findings and Long-Term Mortality After Pulmonary Embolism.

Morris MF, Gardner BA, Gotway MB, Thomsen KM, Harmsen WS, Araoz PA.

Source

Department of Radiology, Mayo Clinic and Mayo Foundation, Scottsdale, AZ.

Abstract

OBJECTIVE:

The utility of CT findings in predicting long-term mortality in patients with acute pulmonary embolism (PE) is unknown. The purpose of this study is to retrospectively determine whether three CT findings-increased embolic burden, interventricular septal bowing toward the left ventricle, and right ventricle-to-left ventricle (RV/LV) diameter ratio greater than 1-are independent predictors of long-term all-cause mortality after acute PE.

MATERIALS AND METHODS:

A total of 1105 patients (47% female; mean age, 63 ± 16 years) with CT scans positive for PE from January 1, 1997, to December 31, 2002, were included. Scans were independently interpreted by two observers, with a third independent observer reviewing discrepant cases. CT findings and clinical information were compared with all-cause mortality using univariate and multivariate logistic regression analyses.

RESULTS:

The median duration of survival was 6.2 years following acute PE, with estimated 10-year survival of 37.4%. CT-derived embolic burden was associated with a very small decrease in long-term all-cause mortality in both univariate (hazard ratio [HR], 0.97; p < 0.001) and multivariate (HR, 0.97; p < 0.001) analyses. Interventricular septal bowing and RV/LV diameter ratio were not significantly associated with long-term all-cause mortality.

CONCLUSION:

CT findings are not predictive of decreased long-term survival after acute PE.