Evidence map›Paper›PMID 31426787›Full record

ArticleRespiratory research2019

A decision tree built with parameters obtained by computed tomographic pulmonary angiography is useful for predicting adverse outcomes in non-high-risk acute pulmonary embolism patients.

Dong Jia, Xue-Lian Li, Qin Zhang, Gang Hou, Xiao-Ming Zhou, Jian Kang

Abstract read
In one paragraph

Article in Respiratory research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Dong JiaDepartment of Emergency, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, China.
Xue-Lian LiDepartment of Epidemiology, School of Public Health, China Medical University, No.77, Puhe Road, Shenyang, China.
Qin ZhangDepartment of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, No.155, Nanjing North Street, Shenyang, 110001, China.
Gang HouDepartment of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, No.155, Nanjing North Street, Shenyang, 110001, China. hougangcmu@163.com.ORCID http://orcid.org/0000-0003-3438-1764
Xiao-Ming ZhouDepartment of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, 110004, China. zhouxmcmu@163.com.
Jian KangDepartment of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, No.155, Nanjing North Street, Shenyang, 110001, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute pulmonary embolism (APE) is one of the leading causes of death in cardiovascular disease. The 30-day mortality can still be 1.7-15% in non-high-risk APE patients. Some non-high-risk patients can progress into the high-risk group and even die, which is referred to as an adverse outcome. Promoting the diagnosis and predictive ability of adverse short-term prognosis was still a problem that needed to be solved. Computed tomography pulmonary angiography (CTPA) may be a way to promote the predictive ability. Our aim to develop predictive tools based on parameters obtained by computed tomographic pulmonary angiography (CTPA) in the form of a decision tree for use in non-high-risk acute pulmonary embolism (APE) patients.

methodsAdverse outcome was defined within 30 days after admission to the hospital. A decision tree was built to predict adverse outcomes based on discriminating factors screened from cardiac volume and clot characteristics from recursive partitioning analysis and compared with simplified pulmonary embolism severity index (sPESI), Bova scores and risk stratification. The area under the receiver operating characteristic curve (ROC-AUC) was used to confirm the predictive ability.

resultsA total of 38 patients with and 303 patients without adverse outcomes were enrolled. Right ventricular/left ventricular (RV/LV) volume ratio, central pulmonary artery (CPA) embolism and right atria/left atria (RA/LA) volume ratio were used as splits in the decision tree to predict adverse outcomes in all patients. The ROC-AUC was 0.858. In CPA embolism patients, a recursive partitioning analysis was performed with cardiac volume and novel clot burden, but only the obstructing area (OA) ratio was included as a discriminating factor to build a second decision tree. The ROC-AUC for the second decision tree was 0.810. The decision trees were superior to those of sPESI, Bova scores and risk stratification, and there were no significant differences between the two decision trees.

conclusionsA decision tree built by CTPA parameters can predict adverse outcomes in non-high-risk APE patients.

Indexed as

Computed Tomography AngiographyDecision TreesAdultAgedAged, 80 and overCost of IllnessFemaleHeartHumansImage Processing, Computer-AssistedMaleMiddle AgedPredictive Value of TestsPrognosisPulmonary EmbolismRetrospective StudiesComputed tomographic pulmonary angiographyPulmonary arteryPulmonary embolism

Identifiers

PMID31426787
PMCPMC6701135

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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.