Role of Clinical and Echocardiographic Findings in Patients with Acute Pulmonary Embolism: Prediction of Adverse Outcomes and Mortality in 180 Days

Document Type : Original Article


1 Department of Radiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 University of Texas Health at San Antonio, San Antonio, TX, USA

3 Tabriz University of Medical Sciences, Tabriz, Iran.


Background: Pulmonary embolism (PE) can be a possibly mortal disease; therefore, an immediate risk assessment would be imperative to ensure accurate decisions on proper treatment plans. The focus of the present study was to evaluate the prognostic value of clinical, echocardiographic, and helical pulmonary computed tomography angiography findings for adverse outcomes and mortality.
Materials and Methods: A total of 104 patients with PE were retrospectively entered in the present study. Patients were categorized into five groups, including patients who faced an adverse outcome (group 1), patients who expired in 30 days (group 2), patients who expired in 30-90 days (group 3), patients who expired in 90-180 days (group 4), and patients who survived without facing an adverse outcome (group 5). Comorbidities (e.g., malignancy) were obtained from medical records. Logistic regression analysis was performed to detect mortality predictors.
Results: In this study, 16 patients were faced with an adverse outcome. Furthermore, 10, 5, and 2 deaths occurred within 30, 30-90, and 90-180 days, respectively. The most frequent presentation was dyspnea (89%). The mean intensive care unit stay (OR=1.202; P=0.036), the predicted 30-day mortality, and a history of kidney transplantation (OR=0.011; P=0.002) were related to less probability of death within 30 days.
Conclusion: The results of this study revealed that a history of kidney transplantation is independently accompanied by a lower occurrence of expiration in 30 days. Moreover, there was a significant correlation between the pulmonary embolism severity index, heart rate of > 100 beats per minute, chest pain, hypoxia, and pulmonary arterial pressure with the pulmonary artery obstruction index (PAOI).