RT Journal Article
T1 Prognostic Significance of Findings on CTPA Supporting an Alternative Diagnosis to PE Among Patients Hospitalized for an Exacerbation of COPD: Predefined Subanalysis of the SLICE Trial.
T2 Significado pronóstico de los diagnósticos alternativos a la TEP hallados en la tomografía computarizada de tórax de pacientes ingresados por agudización de EPOC: subanálisis predefinido del ensayo SLICE.
A1 Rodríguez, Carmen
A1 Solier, Aurora
A1 Marín, Marta
A1 Tenes, Andrés
A1 Durán, Diego
A1 Retegui, Ana
A1 Muriel, Alfonso
A1 Otero, Remedios
A1 Monreal, Manuel
A1 Jiménez, David
A1 SLICE investigators, 
K1 COPD
K1 Computed tomography
K1 EPOC
K1 Prognosis
K1 Pronóstico
K1 Pulmonary embolism
K1 Tomografía computarizada de tórax
K1 Tromboembolia de pulmón
AB Among patients hospitalized for an exacerbation of chronic obstructive pulmonary disease (COPD), the SLICE trial showed that the addition of an active diagnostic strategy for pulmonary embolism (PE) to usual care compared with usual care alone did not improve a composite set of health outcomes. The objective of this subanalysis was to determine the frequency and prognostic significance of findings on computed tomography pulmonary angiogram (CTPA) supporting an alternative diagnosis to PE. We analyzed all patients randomized to the intervention in the SLICE trial who received a CTPA that did not show PE. We used multivariable logistic regression to assess the independent association between findings supporting an alternative diagnosis to PE and a composite of readmission for COPD or death within 90 days after randomization. Among the 746 patients who were randomized, this subanalysis included 175 patients in the intervention group who received a CTPA that did not show PE. Eighty-four (48.0%) patients had acute bronchial infection, 13 (7.4%) had lung cancer, 10 (5.7%) had congestive heart failure, 8 (4.6%), 18 (10.3%) had other diagnoses, and 42 (24.0%) had a normal CTPA. In multivariable analysis, findings supporting an alternative diagnosis to PE were not significantly associated with the primary outcome (odds ratio: 0.64; 95% confidence interval: 0.30-1.38; P=0.26). Among patients hospitalized for an exacerbation of COPD, CTPA identified an alternative diagnosis in 76% of the patients. However, specific management of these patients was not associated with improved outcomes within 90 days after randomization.
YR 2022
FD 2022-03-21
LK http://hdl.handle.net/10668/22009
UL http://hdl.handle.net/10668/22009
LA en
LA es
DS RISalud
RD Apr 9, 2025