PURPOSE: Higher EKG-score is associated with increased severity of pulmonary hypertension(P-HTN),right ventricular dilatation (RVD) and increased morbidity & mortality in patients with documented acute pulmonary embolism (PE). Therefore, we wanted to investigate the prognostic value of EKG-score in our patients with acute pulmonary embolism.
METHODS: Retrospective chart review of patients diagnosed with PE.Charts reviewed for patients’ characteristics, co-morbidities, EKG-scores, echocardiography results, length of stay, cardiac markers and final outcome. 21-EKG score using sinus tachycardia: 2, incomplete-RBBB:2, complete-RBBB:3, T-wave inversion in leads-V1 through V4(0–12), S-wave in lead-I:0, Q-wave in lead-III:1, inverted-T in lead-III:1 and entire S1Q3T3-complex:2.
RESULTS: 101 charts with primary diagnosis of acute pulmonary embolism documented with CT-angiography or V/Q scan were reviewed; and three subsets of EKG scores were formed with EKG score <6, 6–10 and >10.86.9% patients had EKG score <6. There was no significant correlation between higher EKG-score and pulmonary HTN (p-value:0.404), right ventricular dilatation (p-value:0.565), length of stay (p-value:0.417) and mortality (p-value:0.923). However higher EKG score >10 was significantly associated with elevated troponins (p-value:0.001). Also mortality rate was not higher in patients with EKG score >6 and pulmonary-HTN or right ventricular dilatation documented on 2-D echocardiography as compared to low EKG-score and absence of pulmonary-HTN or right ventricular dilatation.
CONCLUSION: Higher EKG-score is not prevalent in our patient population of pulmonary embolism. Also higher EKG-score does not correlate with RVD, P-HTN or increased LOS. EKG-score did not predict increased mortality in our PE patients. However, EKG-score was associated with elevated troponin in our PE patients.
CLINICAL IMPLICATIONS: Higher EKG-score indicates the need to order cardiac markers to look for evidence of cardiac ischemia or injury in patients with acute PE. Otherwise EKG-score will not predict morbidity or mortality in acute PE.
DISCLOSURE: Kaleem-ud Din, No Financial Disclosure Information; No Product/Research Disclosure Information