Abstract:Objective To explore the value of CT pulmonary angiography (CTPA) parameters combined with Wells score in the assessment of the short-term prognosis of acute pulmonary embolism (APE), and to analyze the influencing factors of poor short-term prognosis in patients with APE. Methods A total of 79 patients with APE who were admitted to Hefei Hospital Affiliated to Anhui Medical University from January 2022 to May 2024 were selected for the study, all patients underwent CTPA examination upon admission and the CTPA parameters were recorded. The patients were divided into the adverse outcome group (n=16) and the good outcome group (n=63) based on whether adverse outcome events occurred within 30 days of anticoagulation treatment, and the clinical data of two groups were compared. The logistic multivariate regression analysis method was used to screen out the risk factors that affected the poor short-term prognosis of APE patients, the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of the CTPA parameters combined with the Wells score in predicting the poor short-term prognosis of APE patients. Results Compared with the good outcome group, the proportion of patients aged≥60 years and the Wells score, the ratio of the maximum diameter of the right/left ventricles (RV/LV), the ratio of the inner diameters of the main pulmonary artery/aorta (MPA/ AO), the maximum diameter of the left/right pulmonary arteries (LPA/RPA), the levels of cardiac troponin I (cTnI), N- terminal pro-B-type natriuretic peptide (NT-proBNP), and creatine kinase-muscle/brain type (CK-MB) in the poor outcome group were all higher (P<0.05). Multivariate logistic regression analysis showed that age ≥ 60 years, as well as high Wells score, RV/LV, MPA/AO, LPA/RPA, cTnI, NT-proBNP and CK-MB were independent influence factors for poor short-term prognosis in patients with APE (P<0.05). In predicting poor short-term prognosis in APE patients, the combination of CTPA parameters and the Wells score (AUC=0.905) was superior to any individual CTPA parameter (RV/ LV: AUC=0.813, Z=2.852, P<0.05; MPA/AO: AUC=0.806, Z=2.994, P<0.05; LPA/RPA: AUC=0.817, Z=2.846, P<0.05) or the Wells score alone (AUC=0.822, Z=2.756, P<0.05). Conclusion The combination of CTPA parameters and Wells score has a high efficacy in assessing the poor short-term prognosis of APE patients, providing a theoretical reference for early clinical intervention and prognosis assessment of APE.