Prognostic accuracy of whole lung perfusion blood volume as a predictor of 28-day mortality in acute pulmonary thromboembolism – A prospective study

Résumé fourni par la source

Dear Editor, We read with great interest the article published in Lung India, titled ‘Prognostic Accuracy of Whole Lung Perfusion Blood Volume as a Predictor of 28-Day Mortality in Acute Pulmonary Thromboembolism – A Prospective Study’. We sincerely appreciate the efforts of the researchers in conducting this study and contributing valuable insights to this important clinical topic.[1] We would like to offer the following comments and seek further clarification on certain aspects of the study: The study did not correlate the dual-energy CTPA findings with the pulmonary embolism severity index (SPESI), which would have enhanced the clinical applicability and relevance of the study. Mortality was correlated with factors, such as age, gender, heart rate, oxygen saturation, and tricuspid regurgitation. However, the study did not account for the type, site, or extent of the embolism, which are critical clinical factors influencing patient outcomes. This omission represents a significant limitation.[2] The study compared pulmonary blood volume (PBV), RV/LV diameter ratio between patients with pulmonary embolism (PE) who survived and those who did not. However, the difference was not statistically significant, and the clinical significance of this finding was not discussed.[3] This study establishes a correlation between increased heart rate, reduced oxygen saturation, and higher mortality rates in pulmonary embolism patients. However, as this association is already well recognized, the added clinical value of this test remains uncertain.[4] The follow-up period was short term and did not include actual mortality data, causes of death, or the percentage of deaths specifically due to PE. The study only reported all-cause mortality and evaluated outcomes within 28 days, missing potential insights into long-term mortality and complications associated with PE. Treatment-related mortality was not addressed in the study. The study was conducted at a single centre with a small sample size, which limits the generalizability of its findings to broader and more diverse populations. Given these limitations, it may be more appropriate to consider this as a pilot study.[5] Every study should aim to fulfil the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). However, this study did not appear to meet these criteria. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.