Comparison of PESI, echocardiogram, CTPA, and NT-proBNP as risk stratification tools in patients with acute pulmonary embolism

Akkulagari, Vamsidhar; Rajasekhar, D.; Vanajakshamma, V.; Lakshmi, AY; Latheef, K.; Sankara, C. Siva; Reddy, G. Obul

doi:10.1016/j.ihj.2016.07.010

Cited by 16 publications

(19 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean age of PE cases in the present study (55.5±18.5 years) is similar to 56.5 ± 18.1 years reported in the Emergency Medicine Pulmonary Embolism in the Real World Registry (EMPEROR) study, [19] but higher than 50.5 ± 17.8 years reported in the Angolan study () [14] but lower than the median ages described in some other studies. [20,21] The differences noted with these other studies may be as a result of the small sample size used in the present study.…”

Section: Discussioncontrasting

confidence: 61%

Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

Ogunkoya¹,

Oluwole²,

Adefuye³

et al. 2021

Ann Health Res

View full text Add to dashboard Cite

Background: Pulmonary embolism (PE) is a disease associated with high morbidity and mortality in the more technically advanced western world. However, in Africa and Nigeria in particular, the burden of PE is largely poorly defined as few data are available. Objectives: To characterize the clinical profile, management and outcomes in PE patients confirmed with Computerized Tomography Pulmonary Angiography (CTPA). Methods: A retrospective study was conducted at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. The medical records of PE patients confirmed by CTPA and admitted to the intensive care unit of the hospital spanning July 2016 to June 2020 were retrieved for analysis. Results: Thirty-one patients with the age range of 26 to 93 years were included and the mean age was 55.5±18.5 years. Breathlessness was the most prevalent presenting symptom. In the majority of patients (48.4%), the risk factors were not known. However, the most common risk factor and co-morbidity was pregnancy (16.1%). The in-hospital mortality rate was 9.7%. Conclusion: The clinical characteristics of PE in this cohort were similar to those described in the literature. The high mortality rate in this study also underscores the need for large population studies in black Africans.

show abstract

Section: Discussioncontrasting

confidence: 61%

Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

Ogunkoya¹,

Oluwole²,

Adefuye³

et al. 2021

Ann Health Res

View full text Add to dashboard Cite

show abstract

“…Qanadli scores and Mastora scores were obtained by two radiologists with >20 years of diagnostic imaging experience. They were blinded to the diagnosis and the clot volume measurements.…”

Section: Methodsmentioning

confidence: 99%

“…The semi‐quantitative APE evaluation based on CTPA images has been introduced for the assessment of obstruction degree, using systems such as the Qanadli score and Mastora score . These two evaluation systems have been proposed as predictive biomarkers for predicting the short‐term mortality in patients with APE . However, whether Qanadli score or Mastora score can be used to predict the degree of risk in APE patients is still unclear, because of its low interobserver agreement and lack of accurate objective quantification .…”

Section: Introductionmentioning

confidence: 99%

Risk stratification of acute pulmonary embolism based on the clot volume and right ventricular dysfunction on CT pulmonary angiography

Shen

Wen

et al. 2019

Clinical Respiratory J

View full text Add to dashboard Cite

Objective:To test the feasibility of the clot volume and right ventricular dysfunction for risk stratification of acute pulmonary embolism (APE) patients. Methods: CT pulmonary angiography (CTPA) images of 158 APE patients were collected. After excluding 38 (24.1%) patients due to unsatisfactory quality, 120 APE patients (61 males and 59 females) were divided into high-risk (n = 37) and nonhigh-risk (n = 83) groups. Clot burden was measured by an automated programme (clot volume) and by two semi-quantitative systems (Qanadli and Mastora scores).The ratios of the right ventricular diameter to left ventricular diameter (RVd/LVd) and area (RVa/LVa) were obtained. The correlations amongst the above parameters were analysed. Receiver operating characteristic (ROC) curves were calculated to determine the efficacy of high-risk APE. Multivariate analyses were used to identify the independent predictors. Results: Strong positive correlations were found between the clot volume and both Qanadli score (r 2 = 0.696, P < 0.001) and Mastora score (r 2 = 0.728, P < 0.001), and moderate correlations were found between the clot volume and both RVd/LVd (r 2 = 0.392, P < 0.001) and RVa/LVa (r 2 = 0.389, P < 0.001). The clot volume contributed the highest efficacy (AUC = 0.992) for the identification of high-risk cases, followed by Mastora score (0.968), Qanadli score (0.952), RVa/LVa (0.900) and RVd/LVd (0.892). The clot volume and RVd/LVd were two independent factors of high-risk APE. Conclusions: The clot volume is correlated with semi-quantitative clot burden scores and CT measured cardiac parameters. The clot volume and RVd/LVd were two independent factors of high-risk APE patients. K E Y W O R D Sacute pulmonary embolism, cardiovascular disease, clot burden, CT angiography, risk stratification Bold values indicates significantly different with a P value less than 0.05. Abbreviations: LVa, area of left ventricular; LVd, diameter of left ventricular; RVa, area of right ventricular; RVd, diameter of right ventricular.

show abstract

“…Echocardiographic parameters as independent predictors are readily being explored, 11 with an emphasis on different populations 12,13 as well as different combinations of echocardiographic parameters and risk scores as prognostic factors. 14 Many studies in recent years have explored the balance between keeping patients anticoagulated and thrombosis free as opposed to the associated risk of bleeding. Kaatz et al in 2012 explored the challenge of counterbalancing recurrent VTE risk and the risk of bleeding in regard to treatment duration.…”

Section: Discussionmentioning

confidence: 99%

Predictors for Prognosis in Patients With Nonfatal Pulmonary Embolism: A Registry-Based Cohort Study

Bosevski

Krstevski

Gjorgievski

et al. 2018

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

The article's aim was to determine predictors for short- and long-term prognosis of patients with pulmonary embolism (PE). Cohort prospective study based on the National registry on venous thromboembolism. Eighty-four patients with PE, on age 60.3 + 12.5 years, were selected and followed up in a prospective study. Pulmonary embolism was confirmed by computed tomography angiography in all the patients, while deep venous thrombosis was confirmed by ultrasound in 21 patients. Study population was followed up for 6.7 months. Multivariate regression analysis was done where right ventricular (RV) diameter (mean 37.5 mm), systolic pulmonary artery pressure (68 ± 23 mm Hg) measured by echocardiography, d-dimer level at baseline 2654.5 ± 420.3 ng/mL, number of comorbidities (2.4 ± 0.7), and present symptoms (3.1 ± 0.9) entered the model. The model was age-adjusted. d-dimer level was revealed as a predictor for the length of hospitalization (β = .25, P = .05) and RV diameter as a factor for duration of anticoagulation (β = .29, P = .05). Our results imply that the baseline measurement of these parameters independently influence both the short-term and long-term prognosis of patients with nonfatal PE.

show abstract

Comparison of PESI, echocardiogram, CTPA, and NT-proBNP as risk stratification tools in patients with acute pulmonary embolism

Abstract: Qanadli index is more accurate predictor of adverse events than pulmonary embolism severity index, NT-proBNP, and RVD on echocardiogram and CTPA.

Cited by 16 publications

References 38 publications

Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

Risk stratification of acute pulmonary embolism based on the clot volume and right ventricular dysfunction on CT pulmonary angiography

Predictors for Prognosis in Patients With Nonfatal Pulmonary Embolism: A Registry-Based Cohort Study

Contact Info

Product

Resources

About