OBJECTIVE. The utility of CT findings in predicting long-term mortality in patients with acute pulmonary embolism (PE) is unknown. The purpose of this study is to retrospectively determine whether three CT findings—increased embolic burden, interventricular septal bowing toward the left ventricle, and right ventricle–to–left ventricle (RV/LV) diameter ratio greater than 1—are independent predictors of long-term all-cause mortality after acute PE.

MATERIALS AND METHODS. A total of 1105 patients (47% female; mean age, 63 ± 16 years) with CT scans positive for PE from January 1, 1997, to December 31, 2002, were included. Scans were independently interpreted by two observers, with a third independent observer reviewing discrepant cases. CT findings and clinical information were compared with all-cause mortality using univariate and multivariate logistic regression analyses.

RESULTS. The median duration of survival was 6.2 years following acute PE, with estimated 10-year survival of 37.4%. CT-derived embolic burden was associated with a very small decrease in long-term all-cause mortality in both univariate (hazard ratio [HR], 0.97; p < 0.001) and multivariate (HR, 0.97; p < 0.001) analyses. Interventricular septal bowing and RV/LV diameter ratio were not significantly associated with long-term all-cause mortality.

CONCLUSION. CT findings are not predictive of decreased long-term survival after acute PE.