Retrospective evaluation of the relationship between clot volume score on CT angiography with ECG findings in pulmonary thromboembolism and their relationship with early and late mortality

Abstract

Introduction: Pulmonary thromboembolism (PT) is a widespread and potentially fatal disease with a mortality rate of 2-60% even in the presence of anticoagulation. In recent years, the use of standard 12-lead electrocardiography to determine the risk of premature and late mortality has specifically gained ground in pulmonary embolism (PE). This study aimed to investigate the relationship between the ECG scoring system and that of pulmonary artery clot load in the diagnosis of PT.

Materials and Methods: In this descriptive-analytical cross-sectional study, the relationship between clot volume score in CT angiography (CTA) with ECG findings in PT and their relationship with early and late mortality were investigated retrospectively in patients hospitalized with PE in the pulmonary ward of the Department of Internal Medicine, Tabriz University of Medical Sciences.

Results: This study examined the clinical records of 200 patients (118 males and 82 females) with PE hospitalized in Imam Reza Hospital. The mean ages of male and female patients were 62.95 + 14.76 and 57.12 + 15.03 years, respectively. In CTA findings, massive and sub-massive PE were observed in 111 and 89 patients, respectively. Sinus tachycardia was the most prevalent finding in ECGs of patients. Positive ECG findings were significantly higher in patients with massive PE.

Conclusion: The mean ECG scores were 10.48 + 4.13 and 2.97 + 2.73 in patients with massive PE and sub-massive PE, respectively, with a significantly higher average score in the former group. In-hospital and post-discharge mortalities were found in 23 (11.5%) and nine (5.08%) patients, respectively.