Pulmonary Vascular Volume Estimated by Automated Software is a Mortality Predictor after Acute Pulmonary Embolism

BACKGROUND: Acute pulmonary embolism (APE) has a variable clinical outcome. Computed tomography pulmonary angiography (CTPA) is the gold standard for this diagnosis.

OBJECTIVE: To evaluate if the pulmonary vascular volume (PVV) quantified by automated software is a mortality predictor after APE.

METHODS: Retrospective cohort study where the CTPA imaging of 61 patients with APE was reanalyzed. Pulmonary vascular volume (PVV) and pulmonary volume (PV) were automatically estimated using the Yacta software. We calculated the adjusted PVV by the ratio: PVV(cm3)/PV(liters). Classical prognostic CTPA parameters (clot load index, right ventricle/left ventricle diameter ratio, pulmonary artery/aorta diameter ratio, ventricular septal bowing, pulmonary infarction and reflux of contrast into the hepatic vein) were assessed. The outcome assessed was one-month mortality. We considered a p-value <0.05 as statistically significant.

RESULTS: Seven deaths (11%) occurred at one month among these 61 patients. PVV<23cm3/L was an independent predictor of one-month mortality in the univariate [odds ratio (OR): 26; 95% confidence interval (CI): 3-244; p=0.004] and multivariate analyses [adjusted OR: 19; 95%CI: 1.3-270; p=0.03]. The classical CTPA parameters were not associated with one-month mortality in this sample. The PVV<23cm3/L showed a sensitivity of 86%, a specificity of 82%, a negative predictive value of 94% and a positive predictive value of 64% to identify the patients who died.

CONCLUSION: PVV<23cm3/L was an independent predictor of one-month mortality after APE. This parameter showed better prognostic performance than other classical CTPA findings. (Arq Bras Cardiol. 2020; 115(5):809-818).

Errataetall:

CommentIn: Arq Bras Cardiol. 2020 Nov;115(5):819-820. - PMID 33295443

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:115

Enthalten in:

Arquivos brasileiros de cardiologia - 115(2020), 5 vom: 23. Nov., Seite 809-818

Sprache:

Englisch

Weiterer Titel:

Volume Vascular Pulmonar Estimado por Software Automatizado é um Preditor de Mortalidade após Embolia Pulmonar Aguda

Beteiligte Personen:

Soriano, Leonardo [VerfasserIn]
Santos, Marcel Koenigkam [VerfasserIn]
Wada, Danilo Tadeu [VerfasserIn]
Vilalva, Kelvin [VerfasserIn]
Castro, Talita Tavares [VerfasserIn]
Weinheimer, Oliver [VerfasserIn]
Muglia, Valdair Francisco [VerfasserIn]
Pazin Filho, Antonio [VerfasserIn]
Miranda, Carlos Henrique [VerfasserIn]

Links:

Volltext

Themen:

Journal Article

Anmerkungen:

Date Completed 29.12.2020

Date Revised 28.10.2021

published: Print

CommentIn: Arq Bras Cardiol. 2020 Nov;115(5):819-820. - PMID 33295443

Citation Status MEDLINE

doi:

10.36660/abc.20190392

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM318609401