Prognostic value of computed tomographic pulmonary angiography and the pulmonary embolism severity index in patients with acute pulmonary embolism

Blood Coagul Fibrinolysis. 2013 Jan;24(1):64-70. doi: 10.1097/MBC.0b013e32835a72c2.


Pulmonary embolism is a serious and potentially fatal disorder. Pulmonary embolism risk stratification may allow early hospital discharge and outpatient treatment for low-risk patients. Also, it may prevent death by early medical intervention in high-risk groups. We evaluated objectively confirmed pulmonary embolism in 126 patients by multidetector computed tomographic pulmonary angiography at a single center from January 2008 to January 2010. The Pulmonary Severity Embolism Index (PESI), the right ventricle (RV) to left ventricle (LV) diameter (RV/LV) ratio and the vascular obstruction index (VOI) were derived from data extracted from electronic hospital records and image database. A total of six out of 96 patients (6.3%) died during follow-up. There was an association between PESI and mortality (P-value < 0.001 χ² test). PESI class I-II had a 100% negative predictive value for death in 90 days. No association was found between the RV/LV ratio, the VOI and mortality (P-value > 0.05 χ² test). Also, no association was found between the RV/LV ratio and the VOI and PESI (P-value > 0.05 χ² test). PESI is an accurate tool for pulmonary embolism prognostic stratification. It safely discriminates low-risk from high-risk patients regarding death outcome. We were unable to demonstrate an association between image scores and mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Female
  • Follow-Up Studies
  • Heart Ventricles / pathology
  • Hospital Records
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Organ Size
  • Prognosis
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / mortality
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Young Adult