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首页> 外文期刊>Journal of thoracic imaging >Helical CT Pulmonary Angiography Predictors of In-Hospital Morbidity and Mortality in Patients With Acute Pulmonary Embolism.
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Helical CT Pulmonary Angiography Predictors of In-Hospital Morbidity and Mortality in Patients With Acute Pulmonary Embolism.

机译：急性肺栓塞患者的螺旋CT肺血管造影术预测院内发病率和死亡率。

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SUMMARY: PURPOSE To determine if CT variables predict in-hospital morbidity and mortality in patients with pulmonary embolism (PE).MATERIALS AND METHODS CT scans and charts of 173 patients with CT scans positive for PE were reviewed. CT scans were reviewed for leftward ventricular septal bowing, increased right ventricle (RV) to left ventricle (LV) diameter ratio, clot burden, increased pulmonary artery to aorta diameter ratio, and oligemia. Charts were reviewed for severe morbidity and mortality outcomes: death from pulmonary emboli or any cause, and cardiac arrest. Charts were also reviewed for milder morbidity outcomes: intubation, vasopressor use, or admission to an intensive care unit (ICU) and for multiple comorbidities.RESULTS No CT predictor was significantly associated with severe morbidity or mortality outcomes. Ventricular septal bowing and increased RV/LV diameter ratio were both associated with subsequent admission to an ICU (P = 0.004 and P = 0.025, respectively). Oligemia (either lung) was associated with subsequent intubation; right lung oligemia was associated with the subsequent use of vasopressors. After controlling for history of congestive heart failure, ischemic heart disease, and pulmonary disease, both septal bowing and an increased RV/LV diameter ratio remained associated with admission to an ICU.CONCLUSION No CT variables predicted severe in-hospital morbidity and mortality (death from pulmonary embolism, death from any cause, or cardiac arrest) in patients with PE. However, ventricular septal bowing and increased RV/LV diameter ratio were both strongly predictive of less severe morbidity, namely, subsequent ICU admission, and oligemia was associated with subsequent intubation and vasopressor use.
机译：摘要：目的确定CT变量是否可预测肺栓塞（PE）患者的住院发病率和死亡率。材料与方法回顾了173例PE阳性的CT扫描和图表。回顾了CT扫描，以了解左室间隔弯曲，右心室（RV）与左心室（LV）直径比增加，血块负担，肺动脉与主动脉直径比增加以及低尿血症。检查图表以了解严重的发病率和死亡率：肺栓塞或任何原因导致的死亡以及心脏骤停。还对图表进行了回顾，以发现较轻的发病结果：插管，使用血管加压药或进入重症监护病房（ICU）以及多种合并症。结果没有CT预测因子与严重的发病率或死亡率显着相关。室间隔弯曲和右室/左室直径比的增加均与随后入住ICU有关（分别为P = 0.004和P = 0.025）。低脂血症（任一肺部）与随后的插管有关;右肺低钠血症与随后使用升压药有关。在控制了充血性心力衰竭，局部缺血性心脏病和肺部疾病的病史后，间隔弯曲和右室/左室直径比的增加仍与入ICU有关。结论没有CT变量可预测严重的医院内发病率和死亡率（死亡） PE患者因肺栓塞，任何原因死亡或心脏骤停）。但是，室间隔弯曲和右室/左室直径比的增加均强烈预示了较低的发病率，即随后的ICU入院，而低尿症与随后的插管和使用升压药有关。

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