AJR:198, June 2012
Michael F. Morris Bruce A. Gardner Michael B. Gotway Kristine M.Thomsen W. Scott Harmsen Philip A. Araoz
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.