PURPOSE: To identify clinical presentations and risk factors of clinically suspected acute PE patients and their association with the proven diagnosis by spiral CT in Ramathibodi Hospital.
METHODS: Retrospective study in patients who underwent 64-slide spiral CT pulmonary angiography for excluding acute PE was done between August 2005 and December 2006. The patients were classified as PE and non-PE group by result of imaging. Statistic analysis was STATA program versions 9. The association between variables and the presence of PE was determined by univariate and multivariate analysis.
RESULTS: Eighty two suspected PE patients were enrolled and reviewed of the variable of risk factors and clinical presentations from medical records. Univariate analysis identified 5 variables were statistically significant associated with acute PE including the presence of syncope (p 0.025), D-dimer level (p 0.003), S1Q3T3 pattern (p 0.001), new RBBB pattern (p 0.037), and RV strain (p = 0.024) respectively. However, S1Q3T3 pattern remained statistical significance in multivariate analysis (p=0.001, 95% CI 4.39–291.86, Odds ratio 35.83). While other risk factors including age, either the presence of immobilization or malignancy as well as clinical presentations including dyspnea, hemoptysis, chest pain, hypotension and arterial PaO2 and PaCO2 level were not significantly different between PE and non-PE group.
CONCLUSION: Neither clinical presentations nor risk factors is strongly associated with the presence of acute PE which is diagnosed by spiral CT pulmonary angiography. However the presence of S1Q3T3 EKG pattern is significant and not uncommon in this study.
CLINICAL IMPLICATIONS: Spiral CT pulmonary angiography remains confirmative test in patients with suspiciousness for acute pulmonary embolism therefor this test is required for established diagnosis with regardless to clinical presentations and risk factor.
DISCLOSURE: Theerasuk Kawamatawong, No Financial Disclosure Information; No Product/Research Disclosure Information