Complications of Computed Tomographic Pulmonary Angiography to Rule Out Pulmonary Embolism in a Tertiary Care Cancer & Neuroscience Center
CCCF ePoster library. Alabdrab Alnabi M. Nov 8, 2018; 233387
Disclosure(s): Nothing to disclose.
Dr. Mohammed Alabdrab Alnabi
Dr. Mohammed Alabdrab Alnabi
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Abstract
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BACKGROUND

Pulmonary embolism is a difficult diagnosis, with potentially serious consequences, but computer tomographic pulmonary angiography is also not without complications.

Our hospital is a cancer & neuroscience center with high risk for pulmonary embolism, and high frequency of performing computed tomographies for it.

 

METHODS

This is a prospective observational study designed to measure all the potential complications of computed tomographic pulmonary angiographies in adults (including contrast-induced nephropathy & allergic reactions, as well as lifetime radiation related risk of cancer & cancer mortality). We also measured the incidence of pulmonary embolism & the frequency of its complications (mechanical ventilation, use of vasopressors, & hemorrhage from thrombolysis).

 
RESULTS


We analyzed a sample of 134 consecutive patients who presented to the emergency department between March 2014 & December 2017. We found a 13.4% incidence of contrast-induced nephropathy (18/134 patients). None of them required dialysis & nobody developed allergic reactions. Lifetime risk of cancer attributable to this computed tomog-raphy exposure was estimated to increase by 0.147% & risk of death by 0.071%.


The incidence of confirmed pulmonary embolism in the same sample was 20.1% (27/134 patients), 3 of them died because of pulmonary embolism (representing 11.1% from patients with confirmed pulmonary embolism). 11.2% required mechanical ventilation (15/134 patients), and 5.2% required vasopressors (7/134 patients). Only 1 patient re-quired thrombolytic therapy (0.7%). He did not develop hemorrhage after treatment. Compared to the 11.1% mortality rate of treated cases, the historical mortality rate of undiagnosed & untreated cases has been reported between 26-30%.



CONCLUSION

The incidence of pulmonary embolism & its complications in this patient population was higher & more serious than the incidence of computed tomography complications.

 

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