Monday, March 18, 2013
Published ahead of print in JTI
Recently published ahead of print in Journal of Thoracic Imaging is a study by Cai et al. that retrospectively analyzed clinical characteristics of 1596 consecutive patients with acute pulmonary thromboembolism detected on CT pulmonary angiography and determined predictors of 30-day all-cause mortality. Subjects were divided into two cohorts: those with known malignancy (n=835) and those without (n=761). The reported overall 30-day all-cause mortality rate was 11.7% for the population studied. The 30-day all-cause mortality rate for subjects with known malignancy was 19.6% in contrast to 3.2% for those without known malignancy (p<0.001). Interestingly, the investigators found that odds of 30-day mortality was increased significantly (OR=4.08, 95% CI: 1.67-9.96) for patients without known malignancy when the RV/LV diameter ratio (four chamber view) was greater than 1.0 This variable was not significant in patients with malignancy. In subjects with malignancy, younger age, use of anticoagulation, absence of coronary artery disease, and recent surgery predicted lower mortality. In conclusion, the authors state that the presence or absence of malignancy should be a driver behind risk stratification in patients presenting with acute pulmonary thromboembolism.