Prognostic Value of CT Angiography Findings in Patient with Suspected Active Bleeding

Rational and Objective: This study aimed to identify predictors of 28-day mortality in patients with suspected active bleeding undergoing Computed Tomography Angiography (CTA). Materials and Methods: Retrospective analysis of patients who underwent multi-phasic CTA for suspected active bleeding at a major medical center between January 2019 and November 2021 was performed. The study assessed the association of demographic variables, laboratory data, CTA findings, and interventions performed with 28-day mortality. Statistical analyses included chi-square tests, t-tests, Cox Proportional Hazards Model, and Kaplan-Meier survival curves. Results: A total of 174 patients were analyzed, showing an 18% (n=32) mortality rate within the 28-day period. Cox regression analysis showed that substantial contrast extravasation (HR: 2.49, 95% CI: 1.17 - 5.29, p = 0.018), anticoagulation therapy (HR: 2.46, 95% CI: 1.18 - 5.11, p = 0.016), mean INR (HR: 3.73, 95% CI: 1.78 - 7.82, p < 0.001), and vasopressors use (HR: 4.91, 95% CI: 2.31 - 10.41, p < 0.001) were independently associated with an increased risk of mortality. The type of intervention did not significantly affect mortality rates. Conclusion: Substantial contrast extravasation was the only imaging feature independently associated with increased mortality in patients with suspected active bleeding.