Correlation of Computerized Tomography Angiographic Pulmonary Artery Obstruction Score with Hematologic Outcome and Mortality in Patients with Acute Pulmonary Embolism

Abstract

A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to determine the relationship between the computed tomography obstruction score and radiological parameters, biochemical parameters, and mortality. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : During an 8-month period (January 2011-August 2011), 326 patients with clinically suspected pulmonary embolism (PE) were examined by computerized tomography pulmonary angiography (CTPA). Of these patients, only 95 (49 men and 46 women) were diagnosed with PE. Computerized tomography images were retrieved from the picture archiving and communication system (PACS) for the determination of right ventricle/left ventricle (RV/LV) shortaxis ratio, maximum diameter of the pulmonary artery, and vascular obstruction score according to Qanadli method. We investigated the correlation between continuous values of the Qanadli scoring system and mortality, and determined whether there was a significant difference between mortality and CTPA parameters. The values derived from the morphologic changes in the CTPA, hematological findings and gender where then assessed with respect to their impacts on mortality. R Re es su ul lt ts s: : There was a significant correlation between the PE obstruction score and RV/LV short-axis ratio (r=0.58, p<0.001), RV/LV short-axis ratio, and neutrophil to lymphocyte ratio (NLR) (r=0.21, p=0.035). Survivors and non-survivors had a statistically significant difference in the NLR and midplatelet volume (MPV) (p<0.05). The mortality incidence in patients with an increased MPV (odds ratio 1.689; 95% confidence interval (CI) 1.06-2.67; p=0.025) and older female patients (odds ratio 3.732; 95% CI 1.02-13.65; p=0.04) was higher. C Co on nc cl lu us si io on n: : Our results suggest that in patients with acute PE, NLR and MPV may be of value for the estimation of mortality.K Ke ey y W Wo or rd ds s: : Pulmonary embolism; multidetector computed tomography Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, bilgisayarlı tomografi obstrüksiyon skoru ile radyolojik, biyokimyasal parametreler ve mortalite arasındaki ilişkiyi belirlemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Sekiz aylık periyotta (Ocak 2011-Ağustos 2011), klinik olarak pulmoner emboli kuşkulu 326 hasta bilgisayarlı tomografi pulmoner anjiyografi (BTPA) ile incelendi. Bunların sadece 95'i (49 erkek, 46 kadın) pulmoner emboli tanısı aldı. Bilgisayarlı tomografi imajları sağ ventrikül/sol ventrikül kısa aks oranlarını, pulmoner arter maksimum çapını ve Qanadli obstrüksiyon skorunu saptamak için gö-rüntü saklama ve iletişim sisteminden çağrıldı. Qanadli obstrüksiyon skoru ile mortalite arasındaki ilişki incelendi. Mortalite ve bilgisayarlı tomografi pulmoner anjiyografi parametreleri arasında anlamlı farklılık olup olmadığı araştırıldı. Bilgisayarlı tomografi pulmoner anjiyografideki morfolojik değişikliklerden elde edilen değerler, hematolojik bulgular, cinsiyet ve bunların mortalite üzerin-deki etkileri değerlendirildi. B Bu ul lg gu ul la ar r...

The Prognostic Value of Hematological Parameters in Patients with Pulmonary Embolism

“…In another study conducted by Yeşildağ et al, the relationships of computerized tomography obstruction score (Qanadli obstruction score) with NLR and MPV were investigated in 95 patients, who were diagnosed with PE by computerized tomography pulmonary angiography (CTPA). In this study, when right ventricle / left ventricle short axis ratios and NLR were compared with survival rate and mortality, mortality was significantly related to NLR and MPV [14]. In our study, radiological findings were not evaluated.…”