Should we use prognostic scores for acute pulmonary thromboembolism in clinical practice?

Gazzana, Marcelo Basso; Benedetto,

doi:10.1590/1806-3713/e20190036

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…In the PIOPED study, 17% of patients had defects isolated to the subsegmental pulmonary arteries [25]. A systematic review and meta-analysis showed no difference between patients with subsegmental PE treated with anticoagulation and those not treated, with regard to the pooled outcomes of a 3-month incidence of recurrent VTE and all-cause mortality [26]. Thus, the indication of anticoagulation should be individualized in patients with incidentally diagnosed PE who have no additional risk factors such as cancer.…”

Section: Cardiac Imagingmentioning

confidence: 99%

“…They do not adequately identify those normotensive patients who are at a higher risk and require intensive monitoring [3,26]. For this purpose, alternative scores such as the BOVA, TELOS, and CAPE scores seem more appropriate [26].…”

Section: Re-stratifying Intermediate-risk Patientsmentioning

confidence: 99%

“…The most frequently used non-cancer-specific prediction rules, such as the PESI, sPESI, and Geneva score, include cancer as a relevant predictor of mortality, even though these patients may be at low risk and successfully treated as outpatients [26]. Those prediction rules fail to account for cancer-specific disease characteristics by including cancer as a generic variable.…”

Section: Specific Populations: Patients With Cancermentioning

confidence: 99%

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How to predict prognosis in patients with acute pulmonary embolism? Recent advances

et al. 2023

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Pulmonary embolism (PE) is the third most frequent cardiovascular disease, characterized by a wide range of presentations and clinical courses. Prognostic assessment is a cornerstone of PE management as it determines the choice of both diagnostic and therapeutic strategies. During the previous decades significant efforts have been made to safely select patients for early discharge or home treatment, but appropriate risk stratification, particularly of intermediate-risk patients, remains challenging. In addition to the guideline-recommended clinical prediction rules, such as Pulmonary Embolism Severity Index (PESI), simplified PESI (sPESI), and/or Hestia criteria, a multimodality approach based also on biomarkers and cardiac imaging is crucial for risk-stratification and for selecting appropriate management of patients. In this review article, we discuss the current methods for predicting short and long-term prognosis in PE patients, focusing on the current guidelines, but also on the most recently proposed clinical prediction rules, biomarkers, and imaging parameters.

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Section: Cardiac Imagingmentioning

confidence: 99%

Section: Re-stratifying Intermediate-risk Patientsmentioning

confidence: 99%

Section: Specific Populations: Patients With Cancermentioning

confidence: 99%

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How to predict prognosis in patients with acute pulmonary embolism? Recent advances

et al. 2023

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Utility of original and simplified pulmonary embolism severity indices in risk stratification of patients with pulmonary embolism: a study from Saudi Arabia

Abuelhassan,

Alsalem,

Alshafa

et al. 2024

Egypt J Chest Dis Tuberc

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Background We aimed to report our experience using both the pulmonary embolism severity index (PESI) and its simplified form (s-PESI) score in evaluating patients with PE admitted at a large Saudi Arabian Hospital. Patients and methods This was a retrospective analysis where the adult (≥14 years old) patients admitted to the hospital of the Armed Forces Hospital Southern Region with the diagnosis of acute PE through 1 year were enrolled. The accuracy of both PESI and s-PESI was evaluated for mortality. Results Two hundred and twelve patients were enrolled. We encountered a significant relation only with the 90, 180 days, 1 year, and overall in-hospital mortality for low versus high-risk classification by the s-PESI score. There was neither a significant correlation between any-period mortality and classes of PESI score nor between low versus high-risk s-PESI score and 30-day mortality. The sensitivity of PESI and s-PESI in predicting mortality were 66.7 and 97.0%, respectively. The area under the curve of PESI and s-PESI were 0.611 (P=0.043), and 0.629 (P=0.005), respectively. Conclusion Besides being an easier tool for stratifying the risk of patients with PE, our data show that the s-PESI score is utilizable in Saudi Arabian patients with PE admitted at a large tertiary hospital. s-PESI and PESI have good potential to predict the prognosis of PE in terms of in-hospital mortality, with higher sensitivity, negative predictive value, and area under the curve for s-PESI versus PESI. There was a significant correlation between the s-PESI and the 90, 180 days, 1 year, and the overall in-hospital mortality. Further prospective multicenter studies are needed.

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Should we use prognostic scores for acute pulmonary thromboembolism in clinical practice?

Cited by 2 publications

References 13 publications

How to predict prognosis in patients with acute pulmonary embolism? Recent advances

How to predict prognosis in patients with acute pulmonary embolism? Recent advances

Utility of original and simplified pulmonary embolism severity indices in risk stratification of patients with pulmonary embolism: a study from Saudi Arabia

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