Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients With Acute Symptomatic Pulmonary Embolism
2010/08/09 by David Jiménez · 32 citations
Medicine · #Venous Thromboembolism Diagnosis and Management #Atrial Fibrillation Management and Outcomes #Sepsis Diagnosis and Treatment
paper · doi:10.1001/archinternmed.2010.199
Abstract
BACKGROUND: The Pulmonary Embolism Severity Index (PESI) estimates the risk of 30-day mortality in patients with acute pulmonary embolism (PE). We constructed a simplified version of the PESI. METHODS: The study retrospectively developed a simplified PESI clinical prediction rule for estimating the risk of 30-day mortality in a derivation cohort of Spanish outpatients. Simplified and original PESI performances were compared in the derivation cohort. The simplified PESI underwent retrospective external validation in an independent multinational cohort (Registro Informatizado de la Enfermedad Tromboembólica [RIETE] cohort) of outpatients. RESULTS: In the derivation data set, univariate logistic regression of the original 11 PESI variables led to the removal of variables that did not reach statistical significance and subsequently produced the simplified PESI that contained the variables of age, cancer, chronic cardiopulmonary disease, heart rate, systolic blood pressure, and oxyhemoglobin saturation levels. The prognostic accuracy of the original and simplified PESI scores did not differ (area under the curve, 0.75 [95% confidence interval (CI), 0.69-0.80]). The 305 of 995 patients (30.7%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.0% (95% CI, 0.0%-2.1%) compared with 10.9% (8.5%-13.2%) in the high-risk group. In the RIETE validation cohort, 2569 of 7106 patients (36.2%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.1% (95% CI, 0.7%-1.5%) compared with 8.9% (8.1%-9.8%) in the high-risk group. CONCLUSION: The simplified PESI has similar prognostic accuracy and clinical utility and greater ease of use compared with the original PESI.
Cited by
- Predictive Value of the Uric Acid-to-Albumin Ratio for In-Hospital Mortality in Acute Pulmonary Embolism
- Diagnóstico y tratamiento de la embolia pulmonar. Recomendaciones del Grupo de Enfermedad Tromboembólica de la Sociedad Española de Medicina Interna 2024
- Optimizing sPESI with heart rate threshold adjustments for risk stratification in acute pulmonary embolism: A retrospective cohort study
- Platelet to Lymphocyte Ratio in Cardiovascular Diseases: A Systematic Review
- Reduced-Dose Intravenous Thrombolysis for Acute Intermediate–High-risk Pulmonary Embolism: Rationale and Design of the Pulmonary Embolism International THrOmbolysis (PEITHO)-3 trial
- Trends in 90-Day Mortality, Recurrent Venous Thrombosis, and Bleeding in Patients With Pulmonary Embolism
- Prognostic impact of the e-TAPSE ratio in intermediate-high risk pulmonary embolism patients
- Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. [europepmc]
- A simple score for rapid risk assessment of non-high-risk pulmonary embolism. [europepmc]
- Leukocytes and systemic inflammatory response syndrome as prognostic factors in pulmonary embolism patients. [europepmc]
- The value of electrocardiographic abnormalities in the prognosis of pulmonary embolism: a consensus paper. [europepmc]
- Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. [europepmc]
- Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis. [europepmc]
- Improved early right ventricular function recovery but increased complications with catheter-directed interventions compared with anticoagulation alone for submassive pulmonary embolism. [europepmc]
- Comparative Outcomes of Ultrasound-Assisted Thrombolysis and Standard Catheter-Directed Thrombolysis in the Treatment of Acute Pulmonary Embolism. [europepmc]
- Clinical and echocardiographic predictors of mortality in acute pulmonary embolism. [europepmc]
- Sex differences in the characteristics and short-term prognosis of patients presenting with acute symptomatic pulmonary embolism. [europepmc]
- Rationale, Design and Methodology of the Computerized Registry of Patients with Venous Thromboembolism (RIETE). [europepmc]
- The diagnosis and treatment of venous thromboembolism in asian patients. [europepmc]
- Early Use of Echocardiography in Patients With Acute Pulmonary Embolism: Findings From the RIETE Registry. [europepmc]
- Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium. [europepmc]
- Hospital volume and outcomes for acute pulmonary embolism: multinational population based cohort study. [europepmc]
- Intermediate-High Risk Pulmonary Embolism. [europepmc]
- Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism. [europepmc]
- Changes in Care for Acute Pulmonary Embolism Through A Multidisciplinary Pulmonary Embolism Response Team. [europepmc]
- Comparison of 4 Acute Pulmonary Embolism Mortality Risk Scores in Patients Evaluated by Pulmonary Embolism Response Teams. [europepmc]
- American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. [europepmc]
- Crucial considerations: Sex differences in the epidemiology, diagnosis, treatment, and outcomes of acute pulmonary embolism in non-pregnant adult patients. [europepmc]
- Triaging acute pulmonary embolism for home treatment by Hestia or simplified PESI criteria: the HOME-PE randomized trial. [europepmc]
- Venous Thromboembolism During Pregnancy and the Postpartum Period: Risk Factors, Diagnostic Testing, and Treatment. [europepmc]
- Catheter-Directed Thrombolysis vs Anticoagulation in Patients With Acute Intermediate-High-risk Pulmonary Embolism: The CANARY Randomized Clinical Trial. [europepmc]
- Interventional therapies for pulmonary embolism. [europepmc]
Related