Key result
Obstruction of segmental pulmonary artery branches increased the odds of developing pulmonary infarction by 40-fold compared to patients without segmental obstruction (95.1% vs 32.6%, OR 40.0).
Why the study?
The study evaluated the effect of pulmonary embolism obstruction level on the development of pulmonary infarction and infarction-related pneumonia.
Does obstruction of segmental branches of the pulmonary artery increase the risk of pulmonary infarction in patients with pulmonary embolism?
Observational (n=107)
No
Does obstruction of segmental branches of the pulmonary artery increase the risk of pulmonary infarction in patients with pulmonary embolism?
Odds Ratio: 40 (95% CI 10.7–148.7)
Absolute Event Rate: 95.1% vs 32.6%
p-value: p=<0.001
The development of pulmonary infarction in patients with pulmonary embolism is strongly associated with the obstruction of segmental branches of the pulmonary artery.
Should not yet change PE management; leaves open whether segmental obstruction warrants targeted infarction surveillance.
The purpose of this work was to study the effect of the obstruction level associated with pulmonary embolism (PE) on development of pulmonary infarction (PI) and infarction-related pneumonia. Materials and Methods. Patients ( n = 105) with PTE identified by results of multislice computed tomography (MSCT) with enhancement of pulmonary vessels were enrolled in the study. Among them patients with high risk PTE, survived the 1st week of the disease ( n = 53), and with community-acquired pneumonia ( n = 54) were present, and in these patients MSCT allowed to detect PTE was performed during week 1. Results. PI was detected in 58 (95.1%) of 61 PTE patients with obstruction of segmental pulmonary artery (PA) branches and 15 (32.6%) of 46 patients without obstruction of segmental arteries ( p < 0.001). In PTE patients with upper obstruction level in PA trunk region, the involvement of segmental branches and PI development were observed in 20.0% of cases, with upper obstruction level in main branches region it was reported, respectively, in 31.8 and 52.3% of patients, and with pulmonary branches involvement – in 80.0 and 100.0% of patients. Conclusion. PI development is associated with obstruction of segmental branches of PA. The incidence of segmental branches involvement and risk of PI are increased in association with decreased upper obstruction level of PA.
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Bachurina et al. (2020) conducted an observational in Pulmonary embolism (n=107). Obstruction of segmental pulmonary artery branches vs. No obstruction of segmental pulmonary artery branches was evaluated on Development of pulmonary infarction (OR 40.0, 95% CI 10.7-148.7, p=<0.001). Obstruction of segmental pulmonary artery branches increased the odds of developing pulmonary infarction by 40-fold compared to patients without segmental obstruction (95.1% vs 32.6%, OR 40.0).
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