Evaluation Of Pulmonary Embolism Index,pulmonary Perfusion Defect Index Combined With PESI Score On Severity And Prognosis Of Acute Pulmonary Embolism

Objective: The purpose of this study is to explore whether the pulmonary embolism index,pulmonary perfusion defect index combined with the PESI score can more effectively evaluate the severity and prognosis of acute pulmonary embolism,to better guide the clinical selection of thrombolysis,surgical embolectomy or outpatient anticoagulation,improve the diagnosis and treatment effect and reduce the mortality rate.Methods: 118 patients with clinically suspected APE diagnosed by dual source computed tomography(DSCT)in our hospital from November 2019 to December 2021 were collected.Dual source CT can scan both computed tomography angiography(CTPA)and dual energy CT pulmonary perfusion imaging(depi)at the same time.According to the location and degree of filling defect or perfusion defect,calculate the pulmonary embolism index and pulmonary perfusion defect index respectively,and divide them into mild,moderate and severe groups according to < 30%,≥ 30% and < 50%,≥ 50%.The basic data of these patients at admission were recorded,and the patients were divided into grades 1-5 according to PESI scoring rules.All patients were followed up for 30 days and divided into survival group or death group according to the prognosis.Logistic regression was used to establish the combined prediction model of pulmonary embolism index,pulmonary perfusion defect index and PESI score.T-test,chi-square test and making receiver operating characteristic(ROC)curve were used to compare and describe the differences between different groups.Results: 1.After 30 days of follow-up,there were 85 people in the survival group,with an average age of 62.39 ± 11.93 years;There were 33 people in the death group,with an average age of 70.12 ± 13.86 years.There was no significant difference in gender distribution between death group and survival group(P > 0.05).The pulmonary embolism index,pulmonary perfusion defect index and PESI score in the death group were significantly higher than those in the survival group(P < 0.001).2.The mortality of patients with ape increased with the increase of pulmonary embolism index,pulmonary perfusion defect index and PESI score.3.The areas under the ROC curve of pulmonary embolism index,pulmonary perfusion defect index,PESI score and combined model for predicting the prognosis of ape were 0.83,0.82,0.87 and 0.89 respectively,and the sensitivity of combined model was the highest.Conclusion:1.Pulmonary embolism index,pulmonary perfusion defect index and PESI score have good predictive value for the prognosis of ape.2.The combination of pulmonary embolism index,pulmonary perfusion defect index and PESI score can improve the predictive value and sensitivity of ape prognosis.