Evidence map›Paper›PMID 31376018›Full record

ArticleEmergency radiology2019

Septal bowing and pulmonary artery diameter on computed tomography pulmonary angiography are associated with short-term outcomes in patients with acute pulmonary embolism.

Mads Dam Lyhne, Jacob Gammelgaard Schultz, Peter J MacMahon, Faris Haddad, Mannudeep Kalra, David Mai-King Tso, Alona Muzikansky, Michael H Lev, Christopher Kabrhel

Erratum issuedAbstract read
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In one paragraph

Article in Emergency radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
3.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 46 citations in OpenAlex.

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  11. Role of CT and MRI in Cardiac Emergencies.Tomography (Ann Arbor, Mich.) · 2022
    Review
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  13. CHAClinical cardiology · 2022
    Article
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  15. Article
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  17. Article
  18. Predictive Value of Pulmonary Artery Distensibility for Short-Term Adverse Clinical Outcomes in Patients with Acute Pulmonary Embolism.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
  19. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Mads Dam LyhneCenter for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Jacob Gammelgaard SchultzCenter for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Peter J MacMahonDepartment of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Dublin, Ireland.
Faris HaddadDepartment of Radiology, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA, 22042, USA.
Mannudeep KalraDepartment of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
David Mai-King TsoDepartment of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Alona MuzikanskyBiostatistics Center, Massachusetts General Hospital, 50 Staniford Street, Boston, MA, 02114, USA.
Michael H LevDepartment of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Christopher KabrhelCenter for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. ckabrhel@partners.org.ORCID http://orcid.org/0000-0002-8699-7176
Massachusetts General Hospital · USAarhus University Hospital · DKInova Fairfax Hospital · USMater Misericordiae University Hospital · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with acute pulmonary embolism (PE) can quickly deteriorate and the condition has high mortality due to right ventricular (RV) failure. Immediately available predictors of adverse outcome are of major interest to the treating physician in the acute setting. The purpose of the present study was to evaluate if easily attainable measurements of RV function from the diagnostic computed tomography pulmonary angiography (CTPA) provide information for fast risk stratification in patients with acute PE.

methodsWe retrospectively evaluated images from CTPA in 261 patients (age median 60 years, 50% females) enrolled in a prospective study. RV and left ventricular (LV) diameters and their ratio, the presence of septal bowing, contrast reflux in the inferior vena cava, and the diameter of the central pulmonary arteries (PA) were measured. The composite outcome was 5-day severe adverse events including death, acute decompensation, or need for emergent treatment. We used Wilcoxon rank sum test and Fischer's exact test to test between groups and multivariate logistic regression for prediction.

resultsIn multivariate analysis, increased diameter of the main PA (OR = 1.08 per 1 mm increase, p = 0.047) and the presence of septal bowing (OR = 2.23, p = 0.055) were associated with severe adverse events. RV/LV > 1 did not predict severe outcomes (OR = 0.73, p = 0.541).

conclusionsTwo easily attainable parameters of RV function on CTPA, septal bowing and main PA diameter, are associated with short-term adverse outcomes in patients with acute PE. Further study is required to determine whether these findings can be incorporated into clinical treatment algorithms.

Indexed as

Computed Tomography AngiographyAcute DiseaseAgedContrast MediaFemaleHeart VentriclesHumansIopamidolMaleMiddle AgedPulmonary ArteryPulmonary EmbolismRetrospective StudiesVena Cava, InferiorContrast MediaIopamidolAcute pulmonary embolismComputed tomographyEmergency carePredictorsRight ventricular function

Identifiers

PMID31376018
OpenAlexW2965925347

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.