BACKGROUND: In patients with acute pulmonary embolism (PE), risk stratification is indicated for tailoring of both diagnostic strategies and acute treatment. Whether embolic burden assessed at computed tomography (CT) angiography has a role in risk stratification in these patients is debated. OBJECTIVE: To systematically review and perform a meta-analysis to evaluate the role of CT-assessed burden associated with embolic obstruction and embolic localization in the prognostic stratification of patients with acute PE. METHODS: We performed a systematic search in EMBASE and MEDLINE up until 30 June 2013. Studies reporting on the 30-day outcome of patients with confirmed PE and CT-assessed embolic burden were included. The study outcome was death. RESULTS: Thirty studies reporting on the prognostic value of CT-assessed embolic burden met the inclusion criteria for this systematic review; of these, 19 were included in the meta-analysis. Five studies (2215 patients) were included in the analysis of localization: an association between embolus localization in the central arteries and 30-day mortality was found after heterogeneity was resolved (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.29-3.89, I(2) = 0%). No correlation was observed between obstruction index (according to the Qanadli scoring system) and 30-day mortality after heterogeneity was reduced (16 studies, 3884 patients, OR 1.22, 95% CI 0.99-1.51, I(2) = 27%). CONCLUSION: Localization of emboli assessed at CT angiography can be used for risk stratification in patients with acute PE. Moreover, no correlation was observed between obstruction index and prognosis.
BACKGROUND: In patients with acute pulmonary embolism (PE), risk stratification is indicated for tailoring of both diagnostic strategies and acute treatment. Whether embolic burden assessed at computed tomography (CT) angiography has a role in risk stratification in these patients is debated. OBJECTIVE: To systematically review and perform a meta-analysis to evaluate the role of CT-assessed burden associated with embolic obstruction and embolic localization in the prognostic stratification of patients with acute PE. METHODS: We performed a systematic search in EMBASE and MEDLINE up until 30 June 2013. Studies reporting on the 30-day outcome of patients with confirmed PE and CT-assessed embolic burden were included. The study outcome was death. RESULTS: Thirty studies reporting on the prognostic value of CT-assessed embolic burden met the inclusion criteria for this systematic review; of these, 19 were included in the meta-analysis. Five studies (2215 patients) were included in the analysis of localization: an association between embolus localization in the central arteries and 30-day mortality was found after heterogeneity was resolved (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.29-3.89, I(2) = 0%). No correlation was observed between obstruction index (according to the Qanadli scoring system) and 30-day mortality after heterogeneity was reduced (16 studies, 3884 patients, OR 1.22, 95% CI 0.99-1.51, I(2) = 27%). CONCLUSION: Localization of emboli assessed at CT angiography can be used for risk stratification in patients with acute PE. Moreover, no correlation was observed between obstruction index and prognosis.
Authors: Yang Fan; He Huang; Jun Xiong; Mei Yang; Bin Kong; Jia-Fen Liao; Wang-Wei He; Zhi-Qiang Wang Journal: J Huazhong Univ Sci Technolog Med Sci Date: 2016-04-13
Authors: P Jiménez-Fonseca; A Carmona-Bayonas; C Font; J Plasencia-Martínez; D Calvo-Temprano; R Otero; C Beato; M Biosca; M Sánchez; M Benegas; D Varona; L Faez; M Antonio; I de la Haba; O Madridano; M P Solis; A Ramchandani; E Castañón; P J Marchena; M Martín; F Ayala de la Peña; V Vicente Journal: Clin Transl Oncol Date: 2017-07-10 Impact factor: 3.405
Authors: Halil Doğan; Albert de Roos; Jacob Geleijins; Menno V Huisman; Lucia J M Kroft Journal: Diagn Interv Radiol Date: 2015 Jul-Aug Impact factor: 2.630
Authors: Mads Dam Lyhne; Jacob Gammelgaard Schultz; Peter J MacMahon; Faris Haddad; Mannudeep Kalra; David Mai-King Tso; Alona Muzikansky; Michael H Lev; Christopher Kabrhel Journal: Emerg Radiol Date: 2019-08-02