en Cardiology Cardiology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:14pt"><b><i><span style="color:blue">Background</span></i></b><i><span style="color:blue">:</span></i> Some earlier studies demonstrated an increased mortality risk attributed to delayed pulmonary embolism (PE) diagnosis. Therefore, we mainly aimed to determine the predictors of diagnostic delays and the effect of delayed diagnosis on mortality.<span style="font-size:9.0pt"></span></span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Methods:</span></i></b> We prospectively studied 756 consecutive patients admitted with PE between March 2007 and September 2017. The delayed diagnosis was defined as (1) patient presenting > 7 days after onset of symptoms, (2) diagnosis takes > 24 hours upon arriving in the ED, or (3) undergoing coronary angiography before establishing PE diagnosis.<span style="font-size:10.0pt"></span></span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Results:</span></i></b> A total of 127 (16.7%) patients met the delayed group&rsquo;s criteria. Heart failure (OR= 2.257, 95% CI: 1.130-4.508, P= 0.021), diabetes mellitus (OR= 1.568, 95% CI: 0.996-2.469, P= 0.052), and precordial T wave inversions (OR=2.559, 95% CI: 1.649-3.970, P< 0.001) were linked to higher rates of delayed diagnosis, while hemoptysis (OR=0.254, 95% CI: 0.059-1.087, P= 0.065) and hemodynamic instability (OR= 0.434, 95% CI: 0.168-1.123, P= 0.085) negatively correlated with it. Delayed PE diagnosis did not significantly impact the overall survival during the follow-up. The unadjusted and adjusted mortality hazard ratio for delayed diagnosis were 1.198 (95% CI: 0.758- 1.894, P= 0.439) and 1.215 (95% CI: 0.762- 1.939, P=0.413), respectively.<b> </b>Older age, heart failure, and hemodynamic instability increased the risk of death (p<0.001).<b><i><span style="color:blue"></span></i></b></span><br> <b><i><span style="color:blue">Conclusion</span></i></b><i><span style="color:blue">:</span></i> Hemoptysis, hemodynamic instability, diabetes mellitus, heart failure, and T wave inversions in precordial leads were the independent predictors of delayed diagnosis. Delayed PE diagnosis did not increase the patients&#39; mortality rates.</span></span> Delayed diagnosis, Mortality, Pulmonary embolism, Pulmonary thromboembolism 757 764 http://caspjim.com/browse.php?a_code=A-10-2518-1&slc_lang=en&sid=1 Hassan Aghajani aghajanihas@gmail.com 100319475328460039879 100319475328460039879 No Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Susan Hashemi Susan93h@gmail.com 100319475328460039880 100319475328460039880 No Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Amirali Karimi karimi.amirali.1999@gmail.com 100319475328460039881 100319475328460039881 No School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Somayeh Yadangi yadangi@modares.ac.ir 100319475328460039882 100319475328460039882 No Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Arash Jalali arjalali@tums.ac.ir 100319475328460039883 100319475328460039883 No Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Yaser Jenab yasjenab@gmail.com 100319475328460039884 100319475328460039884 Yes Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran