Association between pulmonary arterial obstruction index and right lateral ventricular wall thickness with in-hospital mortality in patients with acute pulmonary embolism

Emerg Radiol. 2021 Apr;28(2):327-331. doi: 10.1007/s10140-020-01871-5. Epub 2020 Nov 12.

Abstract

Purpose: To retrospectively assess the correlation between pulmonary arterial obstruction index (PAOI) and right lateral ventricular wall thickness with in-hospital mortality in patients with acute pulmonary embolism.

Methods: CT angiography (CTA) of 55 consecutive patients (30 males; 25 females; mean age ± SD, 59 ± 11 years) with proven acute pulmonary embolism was investigated. PAOI was determined according to the Qanadli score on CTA. Right ventricular lateral wall thickness was also measured, and patients' in-hospital mortality was recorded. The correlation between PAOI and mortality, right ventricular lateral wall thickness and mortality, and PAOI and right ventricular lateral wall thickness was evaluated.

Results: PAOI was 23.6 and 10.4 in patients with and without in-hospital mortality, respectively (P < 0.001). Right ventricular lateral wall thickness was 8.7 mm and 7.5 mm in patients with and without in-hospital mortality, respectively (P < 0.001). PAOI more than 21.5 and right ventricular lateral wall thickness more than 8.75 were predictive of in-hospital mortality with a high accuracy. Also, PAOI and right ventricular lateral wall thickness had a significant correlation with each other (P < 0.001; r = 0.695).

Conclusion: PAOI and right ventricular lateral wall thickness on CTA were highly predictive of in-hospital mortality in patients with pulmonary embolism. Right ventricular lateral wall thickness and PAOI had a significant correlation with each other as well.

Keywords: Angiography; CT; Chest; Embolism; Pulmonary artery obstruction index.

MeSH terms

  • Acute Disease
  • Computed Tomography Angiography*
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / mortality*
  • Radiographic Image Interpretation, Computer-Assisted
  • Retrospective Studies