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Purpose <p>To evaluate the prognostic value of computed tomography pulmonary angiography (CTPA)–derived imaging parameters, particularly the right ventricular to left ventricular (RV/LV) diameter ratio, for predicting in-hospital mortality and severe clinical outcomes in patients with acute pulmonary embolism in a community hospital.</p> Materials and methods <p>This retrospective cohort study included adult patients with acute pulmonary embolism confirmed by CTPA between July 2021 and July 2025. The RV/LV diameter ratio was measured on axial images and analyzed as both a continuous variable and dichotomized at ≥ 1.0. Clinical outcomes included in-hospital mortality and a composite severe outcome comprising death, intensive care unit admission, or mechanical ventilation.</p> Results <p>Twenty-four patients were included, most hemodynamically stable at presentation. The median RV/LV ratio was 0.77 (0.39–1.91), with eight patients (33.3%) having a ratio ≥ 1.0. In-hospital mortality occurred in two patients (8.3%), and seven (29.2%) experienced the composite severe outcome. RV/LV ratios were numerically higher in non-survivors than survivors, without statistically significant difference. No significant association was observed between RV/LV ratio and composite severe outcomes in continuous or dichotomized analyses (RR 0.97, 95% CI 0.24–3.88), with substantial overlap between groups.</p> Conclusion <p>In this community hospital cohort, the CTPA-derived RV/LV ratio showed limited ability to discriminate adverse in-hospital outcomes and should be interpreted alongside clinical assessment rather than used as a standalone marker. Given the small sample size and limited number of events, these findings are exploratory and may reflect limited statistical power. Further validation in larger multicenter cohorts is needed.</p>

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CT pulmonary angiography findings and in-hospital outcomes of acute pulmonary embolism in a community hospital

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Sutthatip Intachai

摘要

Purpose

To evaluate the prognostic value of computed tomography pulmonary angiography (CTPA)–derived imaging parameters, particularly the right ventricular to left ventricular (RV/LV) diameter ratio, for predicting in-hospital mortality and severe clinical outcomes in patients with acute pulmonary embolism in a community hospital.

Materials and methods

This retrospective cohort study included adult patients with acute pulmonary embolism confirmed by CTPA between July 2021 and July 2025. The RV/LV diameter ratio was measured on axial images and analyzed as both a continuous variable and dichotomized at ≥ 1.0. Clinical outcomes included in-hospital mortality and a composite severe outcome comprising death, intensive care unit admission, or mechanical ventilation.

Results

Twenty-four patients were included, most hemodynamically stable at presentation. The median RV/LV ratio was 0.77 (0.39–1.91), with eight patients (33.3%) having a ratio ≥ 1.0. In-hospital mortality occurred in two patients (8.3%), and seven (29.2%) experienced the composite severe outcome. RV/LV ratios were numerically higher in non-survivors than survivors, without statistically significant difference. No significant association was observed between RV/LV ratio and composite severe outcomes in continuous or dichotomized analyses (RR 0.97, 95% CI 0.24–3.88), with substantial overlap between groups.

Conclusion

In this community hospital cohort, the CTPA-derived RV/LV ratio showed limited ability to discriminate adverse in-hospital outcomes and should be interpreted alongside clinical assessment rather than used as a standalone marker. Given the small sample size and limited number of events, these findings are exploratory and may reflect limited statistical power. Further validation in larger multicenter cohorts is needed.