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Pulmonary Embolism, Clinical parameters versus Computed Tomography Pulmonary Angiogram.

. Mahmood ul Hassan, Cheragh Hussain, Shahsawar, Samiullah, Muhammad Abbas Khan and Bella Khan


Objective: Pulmonary embolism (PE) is a deadly disease with substantial morbidity and possibly fatal consequences. The treatment success of PE depends on prompt and accurate detection, correct risk stratification, and well-observed anticoagulation. Therefore, this study assessed the clinical manifestation and its association with outcomes in patients with pulmonary embolism.

Methodology: This descriptive cross sectional study was conducted at the coronary care unit of Hayatabad Medical Complex, Peshawar. The duration of the study was from 15th August 2014 till 15August 2021. A total of 153 patients having age above 18 years for both genders with suspected pulmonary embolism having presenting complaint such as dyspnea, tachycardia (heart rate > 100 bpm), cyanosis, hypotension (blood pressure < 90/60 mmHg), hemoptysis, syncope with clinical evidence of DVT, postoperative status, obesity (body mass index ≥ 30 kg/m2), malignancy, immobilization (bed rest for >3 days) were included in the study. Chi square test is applied to find out the association between variables and clinical outcomes. Pearson correlation was applied to correlate variables with Wells score.

Results:The mean age of the study participants was 48.03±15.49 years. The correlation analysis showed that among the patient characteristics studied, weight (p=0.004), right ventricle size (p=0.005) and pulse (p<0.001) had a significant correlation with the Wells score where the correlation of all these characteristics with the Wells score was found to be positive. Among the signs and symptoms, cyanosis was significantly associated with the clinical outcome (p=0.022). Moreover, presence of hypertension was marginally insignificantly associated with the clinical outcome (p=0.061).

Conclusion: This study concluded that clinical manifestation such as cyanosis was significantly associated with clinical outcome. Most of the patients showed positive clinical signs of deep-venous thrombosis. Despite of high and moderate probability of PE patients, mostly patients survived due to timely detection and prompt management.

Keywords: Cyanosis, deep vein thrombosis, hemoptysis, pulmonary embolism.

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