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  1. Online Supplement Right ventricle dysfunction: inter-ventricular septal bowing In 13 studies IVS bowing toward the left ventricle was assessed as a qualitative marker for right ventricle dysfunction (Table 1) [26]. In the majority of the studies IVS bowing was evaluated by a predefined scale and defined as absent or normal septum (ie, convex toward the right ventricle), mild (flattened septum), or definite (septum deviation convex toward the left ventricle). None of the considered studies used an ECG-gated technique for the evaluation of IVS bowing. Seven of these studies were included in a meta-analysis (1422 patients) [22, 26, 28, 29, 34, 43, 52]. IVS bowing was associated with an increased risk for death at 30 days with an odds ratio of 1.83 (95% confidence interval 1.24-2.72, P = 0.003; I squared 0%). No evidence for publication bias was observed in this analysis. Other parameters for right ventricle dysfunction at CT-angiography Other parameters assessed at CT-angiography were considered for their correlation with the risk of death (Table 1). Among the quantitative parameters a non-significant association with adverse outcome was found for: the pulmonary artery to ascending aorta diameter ratio [23, 26, 28, 29] and the pulmonary artery diameter [22, 29, 30, 42]. Right ventricle short axis diameter was shown to be a predictor of death in three studies [24, 29, 43] while in two studies no association was observed with adverse outcome [23, 22, 52]. A meta-analysis was not performed for this marker as data on death were available for three studies only. The diameter of the superior vena cava was shown to be associated to in-hospital mortality [29] and to adverse outcome [43], but this association was not confirmed in four studies [26, 28, 30, 42]. In one study the ejection fraction of both ventricles was calculated [50]. The right ventricle ejection fraction was shown to be a predictor of adverse outcome, while the left ventricle ejection fraction was not. Reflux of the injected contrast medium into the inferior vena cava (IVC) was significantly associated with early mortality in two studies in patients with PE [22, 28, 29]. An association was found between IVC reflux and adverse outcome in two studies [34, 43] and not in one study [26].

  2. Online figure legends Figure S1: Flow chart for study selection

  3. Figure S2: Funnel plot for death within 3 months

  4. Figure S3: Funnel plot for death at 30 days

  5. Figure S4: Funnel plot for death at 30 days in hemodynamically stable patients

  6. Figure S5: Forrest plot fordeath due to PE at 30 days

  7. Figure S6: Funnel plot for death due to PE at 30 days

  8. Figure S7: Forrest plot for death due to PE at 30 days in studies reporting on transverse images

  9. Figure S8: Forrest plot for death due to PE at 30 days in hemodynamically stable patients