The relationship of AST/ALT ratio and shock indices with lung emboli severity and mortality

İntroduction-objective: Pulmonary thromboembolism (PTE) is a common cause of cardiovascular mortality with an increasing incidence of heart failure, respiratory failure and other complications. As right ventricular dysfunction occurs in PTE, it causes hemodynamic instability and may lead to tissue hypoperfusion and increase serum transaminase levels. In our study, we aimed to examine the relationship between AST/ALT ratio, SI, MSI, ASI values and demographic characteristics, admission symptoms, hemodynamic data, laboratory values, mortality risk scoring, presence of DVT, presence of right ventricular dysfunction findings on ECHO, PESI, sPESI, Wells and Geneva scoring, BTPA data, 1-month and 3-month mortality. Methods: Between 30.11.2023-01.05.2024, 133 patients with data on the Hospital Information Management System (HBYS) who were admitted to the emergency department or outpatient clinics of Dicle University Hospital and who were diagnosed with PTE on radiologic imaging were analyzed. AST/ALT ratio was measured in laboratory tests at the first admission. At the same time, SI, MSI, ASI indices calculated at the bedside during the first admission were noted. Results: The mean age of 30133 patients was 62.14 ± 17.13 years. 48.9% (n=65) were male and 51.1% (n=68) were female.The mean AST/ALT ratio was 1.62 ± 0.95 and the number of patients with ≥1.3 was 79.The mean shock index (SI) score was 1.00 ± 0.27, modified shock index (MSI) was 1.33 ± 0.38, and age-related shock index (ASI) was 63.65 ± 28.90. The number of patients with SI≥1 was 78, MSI≥1.4 was 64, and ASI≥54 was 84. AST/ALT≥1.3, SI≥1, MSI≥1.4, ASI≥54 values and demographic characteristics such as age, initial symptoms of instability or arrest, presence of risk factors, elevated cardiac enzymes, and impaired hemodynamic data, Significant correlation was observed between the presence of right heart failure findings on ECHO, high group in mortality risk scoring, PESI, sPESI, Wells, Geneva scores, central weighted thrombus involvement on BTPA, 1-month and 3-month mortality (p<0,005) Conclusion: Today, we found significant associations between AST and ALT values, which can be requested for each patient at initial presentation, and SI, MSI, ASI values, which can be easily calculated at the bedside, and PTE severity and mortality. We believe that the easy availability of these data may facilitate physicians in diagnosis and treatment preference Keywords: pulmonary embolism, transaminases, shock index, mortality