The utility of computed tomography-derived inferior vena cava parameters in predicting outcomes in patients with
Hans-Jonas Meyer1, Veronika Sotikova2, Simon Riegelbauer2
1Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany. hans-jonas.meyer@medizin.uni-leipzig.de.
Insights
A higher inferior vena cava (IVC) flatness index indicates increased 30-day mortality in patients with active bleeding undergoing embolization. This CT-derived parameter shows prognostic significance, warranting further investigation for its clinical utility.
Area of Science:
- Radiology
- Emergency Medicine
- Critical Care Medicine
Background:
- Inferior vena cava (IVC) parameters have prognostic value in emergency settings.
- Limited data exists on IVC parameters in actively bleeding patients.
Purpose of the Study:
- To evaluate the prognostic relevance of IVC parameters in patients with active bleeding.
- To determine if CT-derived IVC measurements can predict outcomes in bleeding patients.
Main Methods:
- Retrospective analysis of 188 patients undergoing transarterial embolization for bleeding.
- Computed tomography (CT) scans used to measure IVC volume and IVC flatness index.
- Multivariable regression analyses incorporating demographic, hemodynamic, and laboratory data.
Main Results:
- A higher IVC flatness index was significantly associated with 30-day mortality (HR 1.27, p=0.038).
- IVC volume did not differ significantly between survivors and non-survivors or between massive transfusion groups.
- No significant association was found between IVC flatness index and massive transfusion.
Conclusions:
- The IVC flatness index may serve as a prognostic indicator for 30-day mortality in bleeding patients treated with embolization.
- Further research is necessary to establish the full prognostic value of CT-derived IVC parameters in this population.
Background:
The inferior vena cava (IVC) parameters are associated with prognostic significance in emergency patients, but there is a lack of data using this parameter in patients with active bleeding.
Objectives:
To investigate the prognostic relevance of IVC parameters in patients with active bleeding.
Patients And Methods:
A retrospective analysis was conducted on consecutive patients who underwent transarterial embolization due to bleeding from different anatomical sites following computed tomography (CT) imaging at a university medical center over a five-year period (2018-2022). The initial CT scan was used to determine the IVC volume and IVC flatness index, which were then incorporated into multivariable regression analyses that included demographic, hemodynamic, and laboratory data.
Results:
The analysis included 188 patients (75.3% male) with a median age of 50 years, and a massive transfusion rate and an all-cause 30-day mortality rate of 26.6% each. Compared with female patients, male patients had a significantly higher median IVC volume (25.45 vs. 15.8 cm³, p < 0.001), whereas the median IVC flatness index was similar for both sexes (14 vs. 14, p = 0.414). Median IVC volumes were similar between 30-day survivors and nonsurvivors (21.6 vs. 20.2 cm³, p = 0.382) and between patients who underwent massive transfusion and those who did not (21.2 vs. 21.5 cm³, p = 0.567). A multivariable Cox proportional hazards model revealed a statistically significant association between the IVC flatness index and 30-day mortality (hazard ratio, 1.27; 95% confidence interval, 1.01-1.59; p = 0.038). Additionally, logistic regression analysis revealed no significant association between the IVC flatness index and massive transfusion (univariable odds ratio, 1.01; 95% confidence interval, 0.75-1.34; p = 0.972).
Conclusions:
A higher IVC flatness index was associated with 30-day mortality in patients undergoing transarterial embolization for active bleeding. Further studies are needed to determine the prognostic value of CT-derived IVC parameters.
More Related Videos
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care