Valor Pronóstico de la Tomografía Computarizada en el Tromboembolismo Pulmonar Agudo: Revisión Sistemática de la Evidencia

Acute pulmonary embolism represents a clinical entity associated with high morbidity and mortality, in which early risk stratification is essential to guide therapeutic management. The aim of this study was to evaluate recent scientific evidence on the prognostic value of computed tomography in patients with acute pulmonary embolism. A systematic review of the literature was conducted in accordance with the PRISMA 2020 recommendations, using a structured search of international electronic databases and including observational studies published between 2021 and 2025. Studies assessing computed tomography–derived parameters from CT pulmonary angiography were analyzed, with particular emphasis on markers related to right ventricular overload and their association with early clinical outcomes, such as 30-day mortality and hemodynamic deterioration. The methodological quality of the included studies was assessed using validated tools for prognostic factor research, and results were synthesized qualitatively due to methodological heterogeneity. The analyzed evidence demonstrated that computed tomography provides relevant prognostic information in acute pulmonary embolism. Signs of right ventricular dysfunction and overload, especially the right-to-left ventricular diameter ratio, were consistently associated with early adverse clinical outcomes. In conclusion, the systematic integration of these tomographic findings improves risk stratification in acute pulmonary embolism, although prospective, multicenter studies with standardized criteria are still required to consolidate their clinical application.