Modification of Simplified Pulmonary Embolism Severity Index and its Prognostic Value in Patients with Acute Pulmonary Embolism

Ostovan, Mohammad Ali; Ghaffari, Samad; Pourafkari, Leili; Dehghani, Pooyan; Hajizadeh, Reza; Nadiri, Mehdi; Ghaffari, Mehdi

doi:10.1016/j.hlc.2015.08.008

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…2 Risk stratification and prognostication is of great importance in patients who present to emergency department with acute PTE, and follows two main purposes: Identifying low-risk patients that can be treated as an outpatient and finding high-risk cases that may benefit from second-line therapies such as thrombolysis or surgical embolectomy. Beside risk stratification tools such as Pulmonary Embolism Severity Index (PESI), 3,4 readily available blood parameters have been recently proposed to be predictors of clinical outcome in venous thromboembolism.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Ghaffari

Parvizian

Pourafkari

et al. 2020

J Cardiovasc Thorac Res

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Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P = 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes. Article info TUOMS P R E S SPlatelets indicies in acute pulmonary thromboembolism

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Section: Introductionmentioning

confidence: 99%

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Ghaffari

Parvizian

Pourafkari

et al. 2020

J Cardiovasc Thorac Res

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“…Previous studies have confirmed that thrombocytopenia is associated with multiple system and organ dysfunction such as ALI, ARDS, capillary leakage syndrome, acute renal failure, and septic shock. 40 , 41 Therefore, thrombocytopenia may lead to adverse outcomes such as patient death through multiple complex pathophysiological pathways. We look forward to more basic research to elucidate the mechanisms behind this.…”

Section: Discussionmentioning

confidence: 99%

Effect of Platelet Parameters on Linezolid-Related Thrombocytopenia in Hospitalized Patients

Zhang,

Yan,

Liao

et al. 2023

IDR

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Background Linezolid-induced thrombocytopenia incidence varies considerably. Linezolid-related thrombocytopenia in patients has received few studies which have investigated risk factors including platelet parameters except for platelet counts. The study aims to analyze the effect of platelet parameters, including mean platelet volume and platelet large cell ratio, on linezolid-related thrombocytopenia in patients. Methods The effect of platelet parameters on linezolid-related thrombocytopenia was identified by univariate and multivariate logistic regressions. A Kaplan–Meier survival analysis was carried out to compare the survival of patients who developed linezolid-related thrombocytopenia with patients who did not. Results Thrombocytopenia occurred at a rate of 41.5% (66/159) after linezolid therapy in hospitalized patients. Platelet parameters, including the difference in mean platelet volume (MPV/fL=0.08 (−1.2–0.9)vs-0.5 (−1.5–0.3), ( OR , 0.459; P = 0.001), the difference in platelet large cell ratio (PLCR/fL=0.9 (−5.1–6.2)vs-3.8 (−8.6–2.4), ( OR , 1.156; P = 0.001), baseline platelet counts ( OR , 0.995; P = 0.006) and duration of linezolid therapy≥10d ( OR , 1.346; P = 0.007), were significantly associated with linezolid-related thrombocytopenia in hospitalized patients. In addition, other risk factors which also are associated with linezolid-related thrombocytopenia include baseline red blood cells, co-medication with parecoxib and co-medication with caspofungin. Accumulated in-hospital mortality of patients with thrombocytopenia was significantly higher than that of patients without thrombocytopenia during linezolid treatment (19.7% vs 8.6%, P = 0.003). Conclusion The difference in mean platelet volume, the difference in large platelet ratio, baseline platelet counts and duration of linezolid therapy≥10d significantly affected the development of linezolid-related thrombocytopenia in hospitalized patients.

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“…The reduction of cardiac motion artifacts allowed for a better visualization of cardiac structures such as the heart septum as well as heart morphology overall. This is important because right-to-left ventricle dilation can be used to evaluate risk of death in patients with PE and in hemodynamically stable patients (16,17).…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Comparison of High-pitch CT at 80 kVp Under Free Breathing with Standard-pitch CT at 100 kVp Under Breath-Hold for Detection of Pulmonary Embolism

et al. 2016

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RATIONALE AND OBJECTIVES To prospectively compare high-pitch computed tomography (HPCT) under free breathing (FB) with standard-pitch CT (SPCT) under breath-hold (BH) for detection of pulmonary embolism (PE). MATERIALS AND METHODS One hundred consecutive patients (47 females; mean age 58.7 ± 16.6) randomly underwent HPCT-FB (n = 50) or SPCT-BH (n = 50). Radiation doses were documented. One reader measured pulmonary artery attenuation and noise; mean signal-tonoise ratio (SNR) was calculated. Two readers assessed image quality, diagnostic confidence for detection of PE, motion artifacts, assessability of anatomical structures, and presence of transient interruption of contrast as sign of Valsalva maneuver. Inter-reader agreement was calculated. RESULTS Radiation dose was significantly lower in HPCT compared to SPCT (2.68 ± 0.60 mGy vs 6.01 ± 2.26 mGy; P < .001). Mean pulmonary artery attenuation and image noise were significantly higher in HPCT (attenuation: 479 Hounsfield unit (HU) vs 343HU; P < .001; noise: 16 HU vs 10 HU; P < .001) whereas SNR was similar between groups (34 HU vs 38 HU; P = .258). HPCT had significantly higher diagnostic confidence for PE detection (P = .048), less cardiac and breathing artifacts (P < .001), better assessability of anatomical structures, and fewer cases of transient interruption of contrast (P < .001) compared to the SPCT. CONCLUSIONS HPCT-FB allows for a significant reduction of breathing and motion artifacts compared to SPCT-BH. Diagnostic confidence, assessability of vascular and bronchial structures, as well as SNR are maintained. Materials and Methods:One hundred consecutive patients (47 females; mean age 58.7 ± 16.6) randomly underwent HPCT-FB (n = 50) or SPCT-BH (n = 50). Radiation doses were documented. One reader measured pulmonary artery attenuation and noise; mean signalto-noise ratio (SNR) was calculated. Two readers assessed image quality, diagnostic confidence for detection of PE, motion artifacts, assessability of anatomical structures, and presence of transient interruption of contrast as sign of Valsalva maneuver. Inter-reader agreement was calculated.Results: Radiation dose was significantly lower in HPCT compared to SPCT (2.68 ± 0.60 mGy vs 6.01 ± 2.26 mGy; P < .001). Mean pulmonary artery attenuation and image noise were significantly higher in HPCT (attenuation: 479 Hounsfield unit (HU) vs 343HU; P < .001; noise: 16 HU vs 10 HU; P < .001) whereas SNR was similar between groups (34 HU vs 38 HU; P = .258). HPCT had significantly higher diagnostic confidence for PE detection (P = .048), less cardiac and breathing artifacts (P < .001), better assessability of anatomical structures, and fewer cases of transient interruption of contrast (P < .001) compared to the SPCT.Conclusions: HPCT-FB allows for a significant reduction of breathing and motion artifacts compared to SPCT-BH. Diagnostic confidence, assessability of vascular and bronchial structures, as well as SNR are maintained.

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Modification of Simplified Pulmonary Embolism Severity Index and its Prognostic Value in Patients with Acute Pulmonary Embolism

Cited by 9 publications

References 23 publications

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Effect of Platelet Parameters on Linezolid-Related Thrombocytopenia in Hospitalized Patients

Prospective Randomized Comparison of High-pitch CT at 80 kVp Under Free Breathing with Standard-pitch CT at 100 kVp Under Breath-Hold for Detection of Pulmonary Embolism

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