Introduction: Patient risk stratification is important in managing individuals with suspected acute pulmonary embolism (APE). The aim of this study was to determine risk factors for in-hospital mortality among real-world patients who had undergone computed tomography pulmonary angiography (CTPA) due to suspected APE.Material and methods: Retrospective analysis of clinical data extracted from the medical documentation of 700 consecutive patients in whom CTPA was performed due to APE suspicion.Results: APE was confirmed in 22.7% of the patients in the sample. In-hospital death was recorded in 10.1% and 12.4% of patients with and without APE confirmed in CTPA, respectively. APE-related death was diagnosed in 37.5% of the APE patients who died during hospitalization. Compared to patients who were discharged from hospital, those who died during hospitalization had a greater prevalence of comorbidities (e.g., neoplasm) and higher values of laboratory determinations and prognostic rule scores. An age-adjusted high-sensitivity troponin I (hs-TNI) cut-off and Pulmonary Embolism Severity Index (PESI) score were found to be independent risk factors of in-hospital death, but only in the whole study group and in patients without APE confirmed in CTPA. The area-under-the-curve value for all the parameters studied was lower than 0.6.Conclusions: Age-adjusted hs-TNI cut-off and PESI score were independent risk factors for in-hospital death in patients with APE suspicion. The predictive power of standard stratifying tools is insufficient in real-world patients with suspected APE. Patients with suspected APE require careful diagnosis and management of comorbidities because these may affect the in-hospital mortality rate.

Introduction: The number of venous interventions continues to rise. The outcome of venous procedures is related to appropriate stent selection and implantation. Aim: To compare the usefulness of magnetic resonance imaging (MRI) and intravascular ultrasound (IVUS) in the determination of target vein section area (VSA) as techniques for selecting an appropriate diameter for a venous stent. Material and methods: VSAs of iliac and common femoral veins obtained in contrast-enhanced MRI (CE-MRI) and non-contrast-enhanced MRI (NCE-MRI) were calculated for 18 consecutive patients with post-thrombotic syndrome (PTS), and VSAs obtained using IVUS were calculated for 15 of these PTS patients. Results: The differences in iliac and common femoral vein VSAs obtained using CE-MRI and NCE-MRI were small and not clinically significant. VSAs of vessels obtained using CE-MRI and NCE-MRI correlated significantly with each other, with R values in the range 0.87-0.97 and p-values < 0.001. However, no significant relationships were found between section areas measured using MRI and IVUS and the differences in measurements was, on average, to 60%. Conclusions: CE magnetic resonance venography can be replaced by Dixon-based NCE-MRI in the preoperative evaluation of patients with PTS who qualify for venous intervention. However, CE-MRI and NCE-MRI performed for ipsilateral and contralateral extremities are not sufficient for appropriate venous stent selection, and IVUS remains a necessary tool in determining venous intervention in iliac veins.