AB 8. Pulmonary embolism severity index, based on spiral CT angiography and V/Q scan, in correlation with d-dimers and P(A-a)O. A retrospective study

Abstract

Background Aim of the study was to apply new, established severity indexes of pulmonary embolism based on spiral CT angiography and V/Q scan and correlate them with the d-dimers levels and P(A-a)O upon admission.

Patients and methods We retrospectively evaluated the files of 46 consecutive patients (27 male - 19 female, mean age 58.5±15 yrs) with pulmonary embolism and clinical and laboratory data were recorded. Sixteen pts had undergone spiral CT angiography and the severity index was evaluated, according to the location, the extent of the embolus and the grade of vascular obstruction. The estimation of the V/Q scan severity index was based upon the quantification of the perfusion decline, in 30 pts compared to 20 healthy age-matched controls.

Results The severity of the disease was classified according to the extent as mild (0-40%) in 25 pts (54.3%) moderate (40-60%) in 8 pts (17.4%) and severe (>60%) in 13 pts (28.3%). In the whole group of pts, the d-dimers levels and P(A-a)O correlated statistically with the disease severity index (P=0.001, P=0.035, respectively) The severity index of each method, when estimated separately, correlated statistically with the d-dimers levels (spiral CT-angiography: P=0,003, V/Q scan: P=0.049) P(A-a)O values did not correlate statistically with the severity index of either method, evaluated separately.

Conclusions D-dimers levels seem to reflect accurately the anatomical extent of pulmonary embolism in both spiral CT angiography and V/Q scan and this finding enhances their credibility in the clinical management of the disease. P(A-a)O is not proved to be a reliable laboratory tool for this purpose, however further analysis of other clinical parameters that may influence its values is required.