Objective: To determine the diagnostic accuracy of the RV/LV ratio for short-term mortality in patients presenting with acute pulmonary embolism using multi-detector CT-pulmonary angiography Study Design: Cross-sectional validation study Place and Duration of Study: Shifa International Hospital, Islamabad; Feb 2021 to December 2022 Methodology: The study employed a consecutive sampling technique to include 176 patients. Patients with a confirmed diagnosis of acute PE on CTPA and high-quality imaging suitable for accurate measurement of right and left ventricular diameters were included. Two blinded radiologists assessed the RV and LV diameters to calculate the RV/LV ratio, with a ratio of >1.1 indicating right ventricular dysfunction. Short-term mortality within 30 days was determined through hospital records and follow-up calls. Results: Among 176 patients, in-hospital mortality was 45(25.6%). Non-survivors had significantly higher RV diameter (42.22±7.68 mm vs. 35.69±7.68 mm, p1.1. ROC analysis showed good diagnostic accuracy of the RV/LV ratio for short-term mortality with an AUC of 0.753 (95% CI: 0.675–0.832). The optimal cut-off value was 1.1, yielding a 75.5% sensitivity and 65.4% specificity, 45.7% positive predictive value and 87.4% negative predictive value. Conclusion: The RV/LV ratio measured on multi-detector CT-pulmonary angiography demonstrates good diagnostic accuracy in predicting short-term mortality among patients with acute pulmonary embolism. Objective: To determine the diagnostic accuracy of the RV/LV ratio for short-term mortality in patients presenting with acute pulmonary embolism using multi-detector CT-pulmonary angiography Study Design: Cross-sectional validation study Place and Duration of Study: Shifa International Hospital, Islamabad; Feb 2021 to December 2022 Methodology: The study employed a consecutive sampling technique to include 176 patients. Patients with a confirmed diagnosis of acute PE on CTPA and high-quality imaging suitable for accurate measurement of right and left ventricular diameters were included. Two blinded radiologists assessed the RV and LV diameters to calculate the RV/LV ratio, with a ratio of >1.1 indicating right ventricular dysfunction. Short-term mortality within 30 days was determined through hospital records and follow-up calls. Results: Among 176 patients, in-hospital mortality was 45(25.6%). Non-survivors had significantly higher RV diameter (42.22±7.68 mm vs. 35.69±7.68 mm, p1.1. ROC analysis showed good diagnostic accuracy of the RV/LV ratio for short-term mortality with an AUC of 0.753 (95% CI: 0.675–0.832). The optimal cut-off value was 1.1, yielding a 75.5% sensitivity and 65.4% specificity, 45.7% positive predictive value and 87.4% negative predictive value. Conclusion: The RV/LV ratio measured on multi-detector CT-pulmonary angiography demonstrates good diagnostic accuracy in predicting short-term mortality among patients with acute pulmonary embolism.
Shafiq et al. (Mon,) studied this question.