| dc.description.abstract | Pulmonary embolism is one of the most common cardiovascular diseases. Determining the prognosis of these patients can be effective in how they are treated and managed. Although the electrocardiography (ECG) currently does not have any specific criteria for a rapid and appropriate diagnosis of pulmonary embolism, it can be used as an effective modality in determining the prognosis of patients due to its low cost and availability. Therefore, in this study, we decided to examine some variables of the ECG and their relationship with the serious and severe side effects of pulmonary embolism.
Materials and Methods: This study was performed in patients aged 18-80 years with acute pulmonary embolism, whose diagnosis was detected by CT angiography or pulmonary perfusion scan in the years 2011-2017 in Shahid Madani Hospital in Tabriz, and in the first 24 hours after the onset of symptoms they had an interpretable ECG (in terms of quality and clarity of the ECG). The patients' clinical records were reviewed and the demographic information and findings of the ECG were recorded in a specific checklist. Then, information about adverse cardiac events (including severe hypotension, the need for mechanical ventilation, syncope, cardiogenic shock, and in hospital death) was extracted from the patients' files, and patients were divided into two groups. They were divided into two groups of without adverse cardiac events (control) and with adverse cardiac events.
Results: 733 patients were examined and the mean age of these patients was 57.63 (15.78%). Of these, 379 patients (51.7%) were male and 354 patients (48.3%) were female. A total of 177 patients (24.1%) had adverse events. Regression analysis showed that age (P = 0.395) and gender (P = 0.0150) were not significantly associated with adverse events. The highest chance of adverse events was among patients with ST elevation in the AVR lead (OR=3.87, 95%= 2.32 – 6.44, P = 0.001). Also, patients with S1Q3T3 were significantly more likely to have adverse events (OR=2.04, 95%CI=1.22 – 3.43, P = 0.007). Other variables in patients' ECGs were not significantly associated with adverse events. The results of the analyzes showed that the predictive power of ST elevation in the aVR lead to adverse events was low (AUC = 0.664). The sensitivity and specificity of this sign were 53.1 and 79.7%, respectively. The results of the analysis showed that the predictive power of S1Q3T3 was poor for adverse events (AUC = 0.64). The sensitivity and specificity of this sign were 59.9% and 68.1%, respectively. | en_US |
