Correlation of Pulmonary Embolism Severity Index and Pulmonary Artery Involvement in Ct Pulmonary Angiogram- Experience in a Tertiary Care Centre

Abstract

BACKGROUND Pulmonary embolism is a common and life-threatening condition. Most of the mortality due to pulmonary embolism occurs within the first few hours of the event. Despite improvement in diagnostic techniques, delays in diagnosis of pulmonary embolism are common. As an aetiology of sudden death, massive pulmonary embolism is second only to sudden cardiac death. In current scenario, it is underdiagnosed. Even though, the diagnosis is established, the choice of treatment decides the prognosis. So, using PESI (pulmonary embolism severity index), we can categorise patients into low-risk group and high-risk group and compared it with CTPA (computed tomography pulmonary angiogram) imaging for level of pulmonary artery involvement. MATERIALS AND METHODS This is a retrospective study for a period of 3 years from January 2013 to June 2016. Total of 50 patients were included in this study. In acute pulmonary embolism, patients who underwent CTPA, PESI clinical score was calculated and correlation was done in between these two. RESULTS Out of 50 patients, 38 are in high-risk group and 12 are in low-risk group. Main pulmonary artery, right/left pulmonary artery were involved in 70% of high-risk group patients, which shows a statistically significant association between risk group (class) and involvement of level of arteries by CT pulmonary angiography (p value 0.001). CONCLUSION  By simply using this, 11 variable PESI score, one can predict the patients who are at high risk in the emergency department itself.  We can decide, which patient should undergo thrombolization according to the risk score.  Patients with high-risk score with immediate thrombolysis will have better results.