AS Al-Adhami, AJ Simpson, JH Reid, M MacDougall, JT Murchison



Aim: To determine whether the survival of patients with suspected acute pulmonary embolism (PE) relates to radiological probability of acute PE assessed using lung scintigraphy scans (LSS).

Methods: Lung scintigraphy scan results from a venous thromboembolism database were categorised as high, indeterminate or low probability using the modified PIOPED criteria and corresponding chest X-rays (CXRs) as normal or abnormal. Mortality data on these cases were obtained from the General Register Office for Scotland, and survival was analysed using the Kaplan-Meier method.

Results: Of the 1,818 LSS analysed, 941 (51.8%) were normal, 532 (29.3%) indeterminate and 345 (19.0%) high probability. After an adjustment for age and gender, no significant survival difference was found between patients with normal and high probability LSS (p=0.182). However, patients with indeterminate LSS had significantly lower survival than patients in the other groups. This difference persisted after adjustment for CXR result.

Conclusions: Indeterminate LSS results are associated with a poor prognosis.Careful follow-up of patients with inderminate LSS would appear to be justified.

Keywords Lung scintigraphy scan, outcome, pulmonary embolism, survival, ventilation perfusion

Declaration of Interests AJ Simpson is the Editor of The Journal of the Royal College of Physicians of Edinburgh. This article was submitted to, and handled exclusively by, the JRCPE’s Clinical Editor and has been peer-reviewed in line with usual JRCPE procedures.