The prognostic role of pulmonary artery thrombus density among patients with intermediate-risk pulmonary embolism
Emergency Radiology, cilt.33, sa.3, ss.461-469, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s10140-025-02427-1
- Dergi Adı: Emergency Radiology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Aerospace Database, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Technology Collection (ProQuest)
- Sayfa Sayıları: ss.461-469
- Anahtar Kelimeler: Pulmonary embolism, Hounsfield unit, Tomography, Angiography, Thrombosis, Risk assessment, Mortality
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. Current risk stratification tools have limitations in predicting short-term outcomes. Radiological parameters such as thrombus density, measured in Hounsfield Units (HU) on computed tomography pulmonary angiography (CTPA), may provide additional prognostic information. Objective: This study aims to assess the association between pulmonary artery thrombus density on CTPA and 30-day mortality in patients with intermediate-risk PE. Methods: This retrospective cohort study included patients diagnosed with acute PE by contrast-enhanced CTPA in the emergency department of a single tertiary center between January 1, 2022, and December 31, 2024. Only patients classified as intermediate-risk according to European Society of Cardiology guidelines were included. HU values were measured from predefined pulmonary artery locations. The primary outcome was 30-day all-cause mortality. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent predictors and assess discriminative ability. Results: A total of 121 patients (mean age: 70 ± 14.5 years; 58.5% male) were analyzed. The 30-day mortality rate was 26.4%. Thrombus HU values were significantly higher in deceased patients compared to survivors (median 76 vs. 56, p = 0.001). In multivariate analysis, HU value (OR: 1.03; 95% CI: 1.001–1.06; p = 0.04) and sPESI score (OR: 1.70; 95% CI: 1.04–2.78; p = 0.03) were independent predictors. AUCs were 0.702 for HU and 0.731 for sPESI. Conclusions: Thrombus density on CTPA was independently associated with 30-day mortality in intermediate-risk PE. HU measurement may serve as a practical imaging biomarker for early prognostic assessment.