Journal of Thrombosis and Thrombolysis

, Volume 34, Issue 2, pp 187–192

Prognostic significance of multidetector computed tomography in normotensive patients with pulmonary embolism: rationale, methodology and reproducibility for the PROTECT study

  • David Jiménez
  • José Luis Lobo
  • Manuel Monreal
  • Remedios Otero
  • Roger D. Yusen

DOI: 10.1007/s11239-012-0709-7

Cite this article as:
Jiménez, D., Lobo, J.L., Monreal, M. et al. J Thromb Thrombolysis (2012) 34: 187. doi:10.1007/s11239-012-0709-7


The PROTECT study is designed to assess the prognostic significance of multidetector computed tomography (MDCT) findings in normotensive outpatients with pulmonary embolism (PE). MDCT assesses right ventricular dysfunction (RVD) by measuring the ratio of the right-to-left ventricular short axis diameters. The study uses 30-day all-cause mortality as the primary outcome. The study determined inter- and intraobserver reproducibility of CT findings of RVD. According to the local radiologists’ measurements, 44 % of patients (42/96) showed RVD (defined as a ratio of the RV to the LV short axis greater than 0.9). The intraclass correlation was good (0.773, CI 95 %, 0.678–0.842). For interobserver reproducibility, the weighted kappa measurement was 0.730. Intraobserver reproducibility was very good (0.932, 95 % CI, 0.880–0.962). The PROTECT study is designed to show the prognostic significance of MDCT for PE. Inter- and intraobserver agreement of interpretation of RVD were good.


Pulmonary embolism Prognosis Computed tomography 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • David Jiménez
    • 1
  • José Luis Lobo
    • 2
  • Manuel Monreal
    • 3
  • Remedios Otero
    • 4
  • Roger D. Yusen
    • 5
  1. 1.Respiratory Department, Ramón y Cajal HospitalIRYCISMadridSpain
  2. 2.Respiratory DepartmentTxagorritxu HospitalVitoriaSpain
  3. 3.Medicine DepartmentGermans Trias I Pujol HospitalBadalonaSpain
  4. 4.Respiratory DepartmentVirgen del Rocío HospitalSevillaSpain
  5. 5.Divisions of Pulmonary and Critical Care Medicine and General Medical SciencesWashington University School of MedicineSt. LouisUSA

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