Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis
Introduction: Pulmonary embolism represents the third leading cause of mortality globally after myocardial infarction with an overall mortality of 30%. ECG findings may play a valuable role in the prognostication of patients with PE, with various ECG abnormalities proving to be reasonable predictors...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English Eng |
| Published: |
Department of Medicine
2025
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867614413866926080 |
|---|---|
| access_status_str | Open Access |
| author | Raghubeer, Nishen |
| author2 | Hendrikse, Clint |
| author_browse | Hendrikse, Clint Raghubeer, Nishen |
| author_facet | Hendrikse, Clint Raghubeer, Nishen |
| author_sort | Raghubeer, Nishen |
| collection | Thesis |
| description | Introduction: Pulmonary embolism represents the third leading cause of mortality globally after myocardial infarction with an overall mortality of 30%. 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 prognostic value of electrocardiography in predicting inpatient mortality in patients with acute pulmonary embolism, as diagnosed with computed tomography pulmonary angiogram. Method: This was a retrospective cohort design study 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. The ECGs were independently screened by two blinded emergency medicine physicians for predetermined signs that are associated with right heart strain and higher pulmonary artery pressures, and these findings were analysed to in-hospital 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41253 |
| institution | University of Cape Town (South Africa) |
| language | English Eng |
| last_indexed | 2026-06-10T12:51:39.455Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41253 The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis Raghubeer, Nishen Hendrikse, Clint Lahri, Sa'ad Emergency Medicine Introduction: Pulmonary embolism represents the third leading cause of mortality globally after myocardial infarction with an overall mortality of 30%. 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 prognostic value of electrocardiography in predicting inpatient mortality in patients with acute pulmonary embolism, as diagnosed with computed tomography pulmonary angiogram. Method: This was a retrospective cohort design study 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. The ECGs were independently screened by two blinded emergency medicine physicians for predetermined signs that are associated with right heart strain and higher pulmonary artery pressures, and these findings were analysed to in-hospital 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. 2025-03-26T12:30:29Z 2025-03-26T12:30:29Z 2024 2025-03-26T12:24:39Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41253 en Eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Emergency Medicine Raghubeer, Nishen The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis |
| thesis_degree_str | Master's |
| title | The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis |
| title_full | The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis |
| title_fullStr | The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis |
| title_full_unstemmed | The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis |
| title_short | The prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism: a retrospective cohort analysis |
| title_sort | prognostic value of electrocardiography to predict inpatient mortality in patients with acute pulmonary embolism a retrospective cohort analysis |
| topic | Emergency Medicine |
| url | http://hdl.handle.net/11427/41253 |
| work_keys_str_mv | AT raghubeernishen theprognosticvalueofelectrocardiographytopredictinpatientmortalityinpatientswithacutepulmonaryembolismaretrospectivecohortanalysis AT raghubeernishen prognosticvalueofelectrocardiographytopredictinpatientmortalityinpatientswithacutepulmonaryembolismaretrospectivecohortanalysis |