Relationship between Computed Tompgraphy Pulmonary Angiography Findings and Clinical Findings Based on Wells Score in Acute Pulmonary Thromboembolism

Acute pulmonary thromboembolism is an emergency disease that can lead to mortality if not diagnosed on time. Proper triage of patients based on clinical findings and the Wells Score will have a significant impact on the medical team's decision-making and patient management.

This descriptive cross-sectional study was conducted on 300 patients selected by the census sampling method. The patients were suspected of acute pulmonary thromboembolism referring to Farshchian Heart Hospital in Hamadan, Iran, within October 2017-March 2020. The cases considered a candidate for computed tomography (CT) pulmonary angiography were selected and compared regarding CT pulmonary angiography results and the risk of embolism based on Wells Score.

According to the results of CT angiography, 91 (30.3%) patients had acute pulmonary thromboembolism, 16.5%, 45.1%, and 38.4% of which were in the low-risk, moderate-risk, and high-risk groups, respectively (P<0.001). Involvement of segmental and subsegmental branches, followed by the involvement of the pulmonary lobar branches, were the most common patterns of pulmonary artery involvement in acute pulmonary thromboembolism. Accompanying findings were significantly lower in patients with acute pulmonary thromboembolism than in patients with negative acute pulmonary thromboembolism (P<0.001(.

There was a significant relationship between the result of CT pulmonary angiography and clinical findings in patients suspected of acute pulmonary thromboembolism. The careful examination of the clinical symptoms of patients and determination of the level of risk in such patients according to the Wells Score can lead to the more efficient management of the process of diagnosis and treatment of patients.