The patient’s clinical condition correlated with pulmonary thromboembolism massiveness, and other instrumental and labaratory studies

Jūratė Siliūnaitė

Lithuanian University of Health Sciences, Radiology clinics.

ABSTRACT

Objective: To evaluate and compare the clinical, laboratory and instrumental studies with pulmonary artery computed tomography (CT) examination results in patients studied for suspected pulmonary, and determine the patient’s clinical condition correlation with embolism massiveness, and right ventricular function.

Material and Methods: A retrospective analysis of patients in LSMU emergency department, in January 2013, for suspected pulmonary CT was introduced (n = 91). Analysis of the data was evaluated: gender, age, systolic and diastolic blood pressure values, SpO2, D-dimer, cardioechoscopy data: pulmonary artery (PA) diameter, PA pressure, right ventricular (RV) size; leg vein ultrasonography. Patients were divided into groups which PATE established and which are not, and a patient with a PATE: shock with clinical signs and without signs of shock. Patients were divided into groups according to pulmonary massiveness using S. Qanadli proposed formula pulmonary arterial vascular obstruction to determine the degree. Based on the degree of vascular obstruction, patients were divided into three groups: microembolization ( 60%). Statistical analysis was performed using SPSS version 22 statistical package. The difference was considered statistically significant at p <0.05.

Results: D-dimer:> 0.5mg/l-96.9 %. There was PATE age group ≤50m-15.6%, > 51m-84.4%; PATE were: age group ≤50m-20%, >51m-80%. p> 0.05. The group, which was PATE: SpO2 average of 94.04 ± 0.85%, D-dimers average: 9.48 ± 3.92 mg/l, the average: systolic blood pressure: 137.13 ± 4,52mmHg, diastolic blood pressure: 86.39 ± 3,74mmHg, average age: 65.76 ± 3,24m; D-dimer average of the PATE was statistically significantly different from the group to which the PATE not p 30mmHg) -85.7 %; RV normal diameter (up to 43mm) -57.1%., RV increased diameter (> 43mm) -42.9 %, the group, which set PATE without shock symptoms: pulmonary massiveness: massive 33.3-%, submassive-27.8%, microembolism-38.9%, P> 0.05; PA-normal pressure 33.3%, increased PA pressure (> 30mmHg) -66.7 % p> 0.05; RV normal diameter (up to 43mm) -88.9%, RV increased diameter (> 43mm) -11.1 %, P> 0.05. In the pulmonary veins and ultrasound examination of the legs, we have 50 percent of thrombus.

Conclusions: PATE much more observed of the elderly. D-dimers average in PATE diagnosed group was significantly higher. The group, which set PATE, systolic and diastolic BP and SpO2 was greater for men than for women, but the D-dimers average significantly different, and statistically significant for women of D-dimers average was higher. In patients with established PATE and clinical signs of shock dominated by a massive embolism. The group without signs of shock dominated microembolism.

Keywords: pulmonary embolism, CT angiography.