LR–PED Rule: Low Risk Pulmonary Embolism Decision Rule – A new decision score for low risk Pulmonary Embolism

Comparison and combination of a hemodynamics/biomarkers-based model with simplified PESI score for prognostic stratification of acute pulmonary embolism: findings from a real world study

“…Despite many prognostic model have been proposed, such as the ESC prognostic model, the original and sPESI score, the Geneva prognostic model, the LR-PED, the HESTIA criteria, the Spanish score and other, which is the best prognosticator for the identification of 30-days mortality in PE patients in real world remains unclear. 4,5,9,10,[17][18][19][20] Moreover, the majority of the proposed prognostic models focus only on early mortality risk without bleeding risk stratification. On the other hand, few bleeding risk scores have been proposed, but, anyway, these do not give information about PE-related early mortality risk.…”

Pulmonary embolism: whom to discharge and whom to thrombolyze?

“…Only 25 among the 142 patients (17.6%) included in the derivation study were considered as low-risk patients and none died during hospitalization or at one month [14]. The PREP score includes cancer, underlying cardiac or respiratory disease, cardiogenic shock, altered mental status, BNP, and right to left ventricle diameter ratio [15].…”

“…The FAST score combines heart-type fatty acid binding protein (H-FABP) (≥ 6 ng mL À1 ), heart rate (> 110 bpm), and syncope [18]. In normotensive patients with PE, the positive predictive value of the FAST score and sPESI for PE-related complications were 22% (95% CI, [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and 11% (95% CI, [8][9][10][11][12][13][14][15][16][17], respectively [18]. Combining patient data from six studies involving 2874 normotensive patients with PE, Bova et al developed a prognostic model for intermediate-risk PE.…”

Atrial fibrillation in acute pulmonary embolism: prognostic considerations

“…The prognostic power of the PESI9 or simplified PESI10 rules has been extensively validated,11–13 but these scores do not include history of AF or AF at admission, although the parameter ‘heart rate above 110 beats per minute’ may indeed include the majority of uncontrolled AF cases. The Low Risk PE Decision (LR-PED) rule, derived from a low-risk cohort of patients, was the first risk score for PE that included AF,14 highlighting the fact that rhythm may be additionally important (alongside rate) when attempting to prognosticate in acute PE.…”