DIAGNOSTIC ACCURACY OF RV/LV RATIO AS A PREDICTOR OF SHORT-TERM MORTALITY IN PATIENTS PRESENTING WITH ACUTE PULMONARY EMBOLISM USING MULTI-DETECTOR CT-PULMONARY ANGIOGRAPHY
DOI:
https://doi.org/10.71000/6f1rse87Keywords:
Mortality, Multi-Detector CT-Pulmonary Angiography, Pulmonary Embolism, RV/LV RatioAbstract
Objective: To determine the diagnostic accuracy of the RV/LV ratio for short-term mortality in patients presenting with acute pulmonary embolism using multi-detector CT-pulmonary angiography
Study Design: Cross-sectional validation study
Place and Duration of Study: Shifa International Hospital, Islamabad; Feb 2021 to December 2022
Methodology: The study employed a consecutive sampling technique to include 176 patients. Patients with a confirmed diagnosis of acute PE on CTPA and high-quality imaging suitable for accurate measurement of right and left ventricular diameters were included. Two blinded radiologists assessed the RV and LV diameters to calculate the RV/LV ratio, with a ratio of >1.1 indicating right ventricular dysfunction. Short-term mortality within 30 days was determined through hospital records and follow-up calls.
Results: Among 176 patients, in-hospital mortality was 45(25.6%). Non-survivors had significantly higher RV diameter (42.22±7.68 mm vs. 35.69±7.68 mm, p<0.001) and RV/LV ratio (1.18±0.24 vs. 0.95±0.25, p<0.001). Among non-survivors, 37(75.5%) patients had RV/LV Ratio >1.1. ROC analysis showed good diagnostic accuracy of the RV/LV ratio for short-term mortality with an AUC of 0.753 (95% CI: 0.675–0.832). The optimal cut-off value was 1.1, yielding a 75.5% sensitivity and 65.4% specificity, 45.7% positive predictive value and 87.4% negative predictive value.
Conclusion: The RV/LV ratio measured on multi-detector CT-pulmonary angiography demonstrates good diagnostic accuracy in predicting short-term mortality among patients with acute pulmonary embolism.
Objective: To determine the diagnostic accuracy of the RV/LV ratio for short-term mortality in patients presenting with acute pulmonary embolism using multi-detector CT-pulmonary angiography
Study Design: Cross-sectional validation study
Place and Duration of Study: Shifa International Hospital, Islamabad; Feb 2021 to December 2022
Methodology: The study employed a consecutive sampling technique to include 176 patients. Patients with a confirmed diagnosis of acute PE on CTPA and high-quality imaging suitable for accurate measurement of right and left ventricular diameters were included. Two blinded radiologists assessed the RV and LV diameters to calculate the RV/LV ratio, with a ratio of >1.1 indicating right ventricular dysfunction. Short-term mortality within 30 days was determined through hospital records and follow-up calls.
Results: Among 176 patients, in-hospital mortality was 45(25.6%). Non-survivors had significantly higher RV diameter (42.22±7.68 mm vs. 35.69±7.68 mm, p<0.001) and RV/LV ratio (1.18±0.24 vs. 0.95±0.25, p<0.001). Among non-survivors, 37(75.5%) patients had RV/LV Ratio >1.1. ROC analysis showed good diagnostic accuracy of the RV/LV ratio for short-term mortality with an AUC of 0.753 (95% CI: 0.675–0.832). The optimal cut-off value was 1.1, yielding a 75.5% sensitivity and 65.4% specificity, 45.7% positive predictive value and 87.4% negative predictive value.
Conclusion: The RV/LV ratio measured on multi-detector CT-pulmonary angiography demonstrates good diagnostic accuracy in predicting short-term mortality among patients with acute pulmonary embolism.
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