The effect of ECG findings in predicting the prognosis of pulmonary thromboembolism

Introduction: Some clinical scoring systems are currently used for prognosis and risk determination in pulmonary thromboembolism (PTE), which can be fatal and is an important cause of chest pain in the emergency department. In our study, electrocardiography (ECG) findings, which are also used as a diagnostic tool, predict the prognosis of PTE. We evaluated the success of seeing. Materials and Methods: Patients diagnosed with PTE because of Computed Tomography Pulmonary Angiography (CTPA) in the emergency department between 01.01.2019-30.06.2021 were retrospectively analyzed. Demographic data, ECG changes, simplified Pulmonary Embolism Severity Index (sPESI) score, and outcomes of the patients were recorded and compared. Results: In our study, the 30-day mortality rate was 6.07%, and the sPESI score had a sensitivity of 98.2% and a specificity of 22.7% in predicting mortality. The most common ECG change detected in the patients was sinus tachycardia with a rate of 43.3%. Of 119 patients with at least one of the four ECG findings statistically associated with mortality (ST elevation in AVR, T negativity in leads V1-2-3, newly diagnosed atrial fibrillation/flutter, and ≥20 ms QTc difference between leads V1-6) comparing the 30-day outcomes compared to those not seen, the relative risk was found to be 1.67, while the sensitivity was 89.6% and the specificity was 62.9%. Conclusions: The presence of at least one of the four ECG findings mentioned above in PTE patients has an acceptable level of close sensitivity and higher specificity than sPESI in predicting the prognosis of patients. ECG evaluation, together with other clinical scoring systems, is very useful in predicting the prognosis of these patients while identifying patients who are suitable for outpatient treatment from patients diagnosed with pulmonary thromboembolism in the emergency department. Keywords: Emergency Service, Pulmonary Thromboembolism, Prognosis, ECG, Simplified Pulmonary Embolism Severity Index