Abstract | INTRODUCTION: OBJECTIVES: The utility of the PaO(2)/PaCO(2) ratio to predict the short-term prognosis of PE is not currently known and that is the aim of the present study. MATERIALS AND METHODS: This study retrospectively enrolled 99 (34 males, 65 females, 67 ± 15 years) consecutive patients with acute PE, diagnosed by spiral chest tomography pulmonary angiography ( CTPA). On admission, cardiac troponin T ( cTn-T) was measured and on CTPA both right ventricle diameter and left ventricle diameter was calculated (RV/LV ratio). During the first 24 h after admission, all the patients had initial arterial blood gas collected under room air. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal PaO(2)/PaCO(2), RV/LV ratio and cTn-T cutoff level with regard to prognosis. RESULTS: In-hospital mortality was 12.1% and all-cause 90-day mortality was 15.2%. Ten of 15 patients who died had a PaO(2)/PaCO(2) ≤ 1.8 based on ROC analysis (P < 0.014).The cutoff level of PaO(2)/PaCO(2) ≤ 1.8 had a high negative predictive value of 93% for mortality. Multivariable analysis revealed that PaO(2)/PaCO(2) ≤ 1.8 Hazard Ratio (HR): 16.8 [95% CI: 2.6-108, P < 0.003] was the most significant independent predictor, whereas cTn-T, pO(2) < 60 mmHg and cardiac failure were nonsignificant factors. In addition, PaO(2)/PaCO(2) ≤ 1.8 showed significant survival differences for overall mortality rates in Kaplan-Meier analysis (P < 0.012). CONCLUSION: The PaO(2)/PaCO(2) measurement is a highly useful and practical measurement to predict prognosis in patients with acute PE. Moreover, it appears to be a more accurate predictor than RV/LV ratio and cTn-T levels in patients with normotensive PE.
|
Authors | Savas Ozsu, Yasin Abul, Ismail Yilmaz, Asiye Ozsu, Funda Oztuna, Yilmaz Bulbul, Tevfik Ozlu |
Journal | The clinical respiratory journal
(Clin Respir J)
Vol. 6
Issue 2
Pg. 104-11
(Apr 2012)
ISSN: 1752-699X [Electronic] England |
PMID | 21651744
(Publication Type: Journal Article)
|
Copyright | © 2011 Blackwell Publishing Ltd. |
Chemical References |
|
Topics |
- Aged
- Blood Gas Analysis
- Blood Pressure
- Carbon Dioxide
(blood)
- Female
- Humans
- Male
- Middle Aged
- Oxygen
(blood)
- Predictive Value of Tests
- Prognosis
- Pulmonary Embolism
(blood, diagnosis, physiopathology)
- Retrospective Studies
- Ventricular Function, Left
(physiology)
- Ventricular Function, Right
(physiology)
|