Saddle Pulmonary Embolism: Laboratory and Computed Tomographic Pulmonary Angiographic Findings to Predict Short-term Mortality
Saddle Pulmonary Embolism: Laboratory and Computed Tomographic Pulmonary Angiographic Findings to Predict Short-term Mortality
复制标题
鞍形肺栓塞：实验室和计算机断层扫描肺血管造影结果可预测短期死亡率
DOI：
10.1016/j.hlc.2016.02.019
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发表时间：
2017-02-01
影响因子：
2.6
通讯作者：
Yang, Yuanhua
中科院分区：
文献类型：
--
作者：
Liu, Min;Miao, Ran;Yang, Yuanhua
鞍状肺栓塞（SPE）是一种罕见的急性肺栓塞，其治疗和预后一直存在争议。我们的目的是评估实验室和计算机断层肺血管造影（CTPA）的结果，以预测短期死亡率的患者SPE.Methods这是一个五中心，回顾性研究。收集了88例SPE患者的临床资料、实验室检查和CTPA检查结果。SPE诊断后一个月的死亡率是主要终点。采用ROC曲线下面积（AUC）和Logistic回归分析方法，分析实验室检查和CTPA检查结果与1个月内死亡率的相关性。受试者工作特征曲线显示，左、右心房内径比、右心室面积比、左心室面积比的截断值（RVa/LVa比值）、Mastora评分、间隔角、N末端脑钠肽前体和心肌肌钙蛋白I（cTnI）检测早期死亡率分别为2.15、2.13、69%、578、3036 pg/mL和0.18 ng/mL，分别使用logistic回归分析的实验室和CTPA结果的SPE，RVa/LVa比值和cTnI的一个月死亡率被证明是独立的早期死亡相关。cTnI和RVa/LVa比值联合检测可使AUC值增加，但与cTnI和RVa/LVa比较差异无显著性（P>0.05）。
Background Saddle pulmonary embolism (SPE) is rare type of acute pulmonary embolism and there is debate about its treatment and prognosis. Our aim is to assess laboratory and computed tomographic pulmonary angiographic (CTPA) findings to predict short-term mortality in patients with SPE.Methods This was a five-centre, retrospective study. The clinical information, laboratory and CTPA findings of 88 consecutive patients with SPE were collected. One-month mortality after diagnosis of SPE was the primary end-point. The correlation of laboratory and CTPA findings with one-month mortality was analysed with area under curve (AUC) of receiver operating characteristic (ROC) curves and logistic regression analysis.Results Eighteen patients with SPE died within one month. Receiver operating characteristic curves revealed that the cutoff values for the right and left atrial diameter ratio, the right ventricular area and left ventricular area ratio (RVa/LVa ratio), Mastora score, septal angle, N-terminal pro-brain natriuretic peptide and cardiac troponin I (cTnI) for detecting early mortality were 2.15, 2.13, 69%, 578, 3036 pg/mL and 0.18 ng/mL, respectively. Using logistic regression analysis of laboratory and CTPA findings with regard to one-month mortality of SPE, RVa/LVa ratio and cTnI were shown to be independently associated with early death. A combination of cTnI and RVa/LVa ratio revealed an increase in the AUC value, but the difference did not reach significance compared with RVa/LVa or cTnI, alone (P>0.05).Conclusion In patients with SPE, both the RVa/LVa ratio on CTPA and cTnI appear valuable for the prediction of short-term mortality.