The value of electrocardiography in predicting inpatient mortality in
patients with acute pulmonary embolism: A cross sectional analysis
Dublin Core
Title
The value of electrocardiography in predicting inpatient mortality in
patients with acute pulmonary embolism: A cross sectional analysis
patients with acute pulmonary embolism: A cross sectional analysis
Subject
Pulmonary embolism
ECG/electrocardiography
Mortality
Emergency centre
LMIC
ECG/electrocardiography
Mortality
Emergency centre
LMIC
Description
Introduction: Pulmonary embolism (PE) is a significant global cause of mortality, ranking third after myocardial
infarction and stroke. ECG findings may play a valuable role in the prognostication of patients with PE, with
various ECG abnormalities proving to be reasonable predictors of haemodynamic decompensation, cardiogenic
shock, and even mortality. This study aims to assess the value of electrocardiography in predicting inpatient
mortality in patients with acute pulmonary embolism, as diagnosed with computed tomography pulmonary
angiogram.
Method: This study was a cross sectional analysis based at Tygerberg Hospital, Cape Town, South Africa. Eligible
patients were identified from all CT-PA performed between 1 January 2017 and 31 December 2019 (2 years).
The ECGs were independently screened by two blinded emergency physicians for predetermined signs that are
associated with right heart strain and higher pulmonary artery pressures, and these findings were analysed to inhospital mortality.
Results: Of the included 81 patients, 61 (75 %) were female. Of the 41 (51 %) patients with submassive PE and 8
(10 %) with massive PE, 7 (17 %) and 3 (38 %) suffered inpatient mortality (p = 0.023) respectively. Univariate
ECG analysis revealed that complete right bundle branch block (OR, 8.6; 95 % CI, 1.1 to 69.9; p = 0.044) and
right axis deviation (OR, 5.6; 95 % CI, 1.4 to 22.4; p = 0.015) were significant predictors of inpatient mortality.
Conclusion: Early identification of patients with pulmonary embolism at higher risk of clinical deterioration and
in-patient mortality remains a challenge. Even though no clinical finding or prediction tool in isolation can
reliably predict outcomes in patients with pulmonary embolism, this study demonstrated two ECG findings at
presentation that were associated with a higher likelihood of inpatient mortality. This single-centre observational
study with a small sample precludes concrete conclusions and a large follow-up multi-centre study is advised
infarction and stroke. ECG findings may play a valuable role in the prognostication of patients with PE, with
various ECG abnormalities proving to be reasonable predictors of haemodynamic decompensation, cardiogenic
shock, and even mortality. This study aims to assess the value of electrocardiography in predicting inpatient
mortality in patients with acute pulmonary embolism, as diagnosed with computed tomography pulmonary
angiogram.
Method: This study was a cross sectional analysis based at Tygerberg Hospital, Cape Town, South Africa. Eligible
patients were identified from all CT-PA performed between 1 January 2017 and 31 December 2019 (2 years).
The ECGs were independently screened by two blinded emergency physicians for predetermined signs that are
associated with right heart strain and higher pulmonary artery pressures, and these findings were analysed to inhospital mortality.
Results: Of the included 81 patients, 61 (75 %) were female. Of the 41 (51 %) patients with submassive PE and 8
(10 %) with massive PE, 7 (17 %) and 3 (38 %) suffered inpatient mortality (p = 0.023) respectively. Univariate
ECG analysis revealed that complete right bundle branch block (OR, 8.6; 95 % CI, 1.1 to 69.9; p = 0.044) and
right axis deviation (OR, 5.6; 95 % CI, 1.4 to 22.4; p = 0.015) were significant predictors of inpatient mortality.
Conclusion: Early identification of patients with pulmonary embolism at higher risk of clinical deterioration and
in-patient mortality remains a challenge. Even though no clinical finding or prediction tool in isolation can
reliably predict outcomes in patients with pulmonary embolism, this study demonstrated two ECG findings at
presentation that were associated with a higher likelihood of inpatient mortality. This single-centre observational
study with a small sample precludes concrete conclusions and a large follow-up multi-centre study is advised
Creator
Nishen Raghubeer a,*
, Sa’ad Lahri b
, Clint Hendrikse a
, Sa’ad Lahri b
, Clint Hendrikse a
Source
https://pdf.sciencedirectassets.com/280685/1-s2.0-S2211419X24X00026/1-s2.0-S2211419X24000041/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjELf%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJHMEUCIQDWAJ2nxe6XEqFbKO2cKZ9n1TDhmckGeqjEfJvroFzFNgIgWUW4LvPDJ18m1UnBvB4mAQG9Ex0p85sYr05Dp43ZqOUquwUIoP%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FARAFGgwwNTkwMDM1NDY4NjUiDIhma118JqIgQweyKCqPBSEItAKGuPIz2LHDUXTwDRpOdXnge74ed%2Bkz7%2FWjFhf21hoaHde4JTKWRoq7Y9uxuCUNbP2YREQV%2BRKKGOZfhZ0%2Bjsvc0gB1cA8AbthGgRDeWKvQMjOKcw6ZNkbqvZcnQCjac20YPGQ9pHcdmPHKPDfm%2FGYBpl5Tnsgqklmi4iB%2BflqW9wx1U2gss007R3wqX1UCQLUnkofkQGV8FpVacq71%2BX%2FQSzmL96ubkMxdW4kxS0huZXPfu8BYzIeW2OqK6fSg22x1aLpu0bzDeeHq6YrK0d%2Fw4W1TgDSRvuFmRA8%2FGxbHlk3EE0BYeQ4jwEsSs8U6ydJMKQEYygsopyF36MTM5uqs1ARBThknsYwTD10P4GmHwOUOvVo7XzdxD2WnrOAC6NduIKlFZY6eew8o0XNLAAhEbjwhGw6IrMlZePFRkLZQBQzmpc2tJUFdX3q%2BUotfcuvzMJo5L5p%2BBPEOGyTjJToMH7ek4bAHmhYUp6CbH8Waudt5pPxroVOqS4N7lmPUZ6b1S0WXvUfpvn4dQslVK81jgThH75h9A3mbtp4VlGFZrhvQgDd8VVKriC8i6MeUC6g37GwOfw%2BYR1OwkXK%2FFHSV6QaCvVslN1HUrjXdEZ78jyiPXlFNjdRh0atkqi5poc8StQ23ev6zad9HXlNhq3Qrhbbod900i%2B42HddYZu7eCvlxE7ARGp9n2pP%2FKE5mnKXL8KGRKd25jMH2w%2Fqf8NhdbxOA0j4oD%2BYsAQtL%2FYPz%2Fkt7oURys30vYnBPNvQ%2BWHqlC082LlRDrdIB%2BQKeHH0w4ZVbXjsDfFB0%2BokXtTdBdLfdSxTwX0h5NK3pzutA%2B8royzWjGeY6eqT6WK1wV8k8jgv8rVmrTCqSRFQw8t7OwgY6sQFP3Nb38lT6UfxmsFjc9Tl9P7FT2eHJMcE9JdH3vo4U6%2BDwwZeXoY44wou%2FAcIeThvRu%2BwzL6MSEub7waRHO%2FUXRLMe%2BLH2dPDsy6llfmKkCDRpxGqbaCsP059Nwfco%2BLRp5JBDiSKFe0AgaNuq5Jvn1wV9NLVDtcxe4qC4gM4VqWzz5z7d%2BNyuOMcILz514U6cUfpeobA0SD4u78xHhS1SnkoEMfZKAsip1yqXi%2FFt3Ec%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250619T074020Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYZHMCDJMS%2F20250619%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=9a2a0470e74c46392df465c2361794a59de7b2f39bb3786bffc548eb00e8af60&hash=0e12b037b8d2e19e8e510d1093e316fae4bd53a9d62b5c2738e4c2b09594ee67&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S2211419X24000041&tid=spdf-80add89f-d64f-4330-a92a-7669ed58d57d&sid=00688b7b811b2744bd985b7238466a2c58a0gxrqb&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&rh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=13025d5356515154005055&rr=952160b06cba4dae&cc=id
Publisher
a Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa b Division of Emergency Medicine, University of Stellenbosch, Stellenbosch, South Africa
Date
25 january 2024
Contributor
Fajar Bagus W
Format
PDF
Language
English
Type
Text
Files
Citation
Nishen Raghubeer a,*
, Sa’ad Lahri b
, Clint Hendrikse a
, “The value of electrocardiography in predicting inpatient mortality in
patients with acute pulmonary embolism: A cross sectional analysis,” Repository Horizon University Indonesia, accessed June 20, 2025, https://repository.horizon.ac.id/items/show/9557.
patients with acute pulmonary embolism: A cross sectional analysis,” Repository Horizon University Indonesia, accessed June 20, 2025, https://repository.horizon.ac.id/items/show/9557.