The Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism

Choi, Won‐Ho; Kwon, Sung Uk; Jwa, Yoon Jung; Kim, Jung A; Choi, Yong-Sung; Chang, Jae Suk; Jung, Hoon; Doh, Joon Hyung; Namgung, June; Lee, Sung Yun; Lee, William R.

doi:10.3904/kjim.2009.24.2.123

Cited by 24 publications

(12 citation statements)

References 12 publications

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“…Nine CPRs were studied 43 times in 37 different cohorts, given that six cohorts of patients were studied for two CPRs [13,[16][17][18]28]. Cohorts ranged in size from 90 [24] to 10 354 patients [17,29], for a total of 35 518 patients.…”

Section: Study Characteristicsmentioning

confidence: 99%

Prognostic clinical prediction rules to identify a low‐risk pulmonary embolism: a systematic review and meta‐analysis

Squizzato

Donadini

Galli

et al. 2012

Journal of Thrombosis and Haemostasis

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To cite this article: Squizzato A, Donadini MP, Galli L, Dentali F, Aujesky D, Ageno W. Prognostic clinical prediction rules to identify a low-risk pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 2012; 10: 1276-90.Summary. Background: Prognostic assessment is important for the management of patients with a pulmonary embolism (PE). A number of clinical prediction rules (CPRs) have been proposed for stratifying PE mortality risk. The aim of this systematic review was to assess the performance of prognostic CPRs in identifying a low-risk PE. Methods: MEDLINE and EMBASE databases were systematically searched until August 2011. Derivation and validation studies that assessed the performance of prognostic CPRs in predicting adverse eventsrisk in PE patients were included. Weighted mean proportion and 95% confidence intervals (CIs) of adverse events were then calculated and pooled using a fixed and a random-effects model. Statistical heterogeneity was evaluated through the use of I 2 statistics. Results: Of 1125 references in the original search, 33 relevant articles were included. Nine CPRs were assessed in 37 cohorts, for a total of 35 518 patients. Pulmonary Embolism Severity Index and prognostic Geneva CPR were investigated in 22 and 6 cohorts, respectively. Eleven (29.7%) cohorts were of high quality. The median follow-up was 30 days. In low-risk PE patients, pooled short-term mortality (within 14 days or less) was 0.7% (95% CI 0.3-1.1%, random-effects model; I 2 = 49.6%), 30-day mortality was 1.7% (95% CI 1.1-2.3%, random-effects model; I 2 = 82.4%) and 90-day mortality was 2.2% (95% CI 1.2-3.4%, random-effects model; I 2 = 59.8%). Conclusions: Prognostic CPRs efficiently identify PE patients at a low risk of mortality. Before implementing prognostic CPRs in the routine care of PE patients, welldesigned management studies are warranted.

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Section: Study Characteristicsmentioning

confidence: 99%

Prognostic clinical prediction rules to identify a low‐risk pulmonary embolism: a systematic review and meta‐analysis

Squizzato

Donadini

Galli

et al. 2012

Journal of Thrombosis and Haemostasis

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“…Major underlying conditions (cancer and cardiac or respiratory disease), clinical signs of right ventricular dysfunction (tachycardia and hypotension) and hypoxemia, and frailty in the elderly are the main clinical determinants of the outcome of patients with pulmonary embolism. Risk management poses a significant challenge when facing complex decisions regarding potential use of invasive procedures in older patients in the management of pulmonary embolism [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Psoas Muscle Area Measured with Computed Tomography at Admission to Intensive Care Unit: Prediction of In-Hospital Mortality in Patients with Pulmonary Embolism

Akkoç

Toptaş

Yalcin

et al. 2020

BioMed Research International

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Aim. Sarcopenia, a core component of physical frailty, is an independent risk factor for suboptimal health outcomes in hospitalized patients, especially in the intensive care patients. Psoas muscle areas can be assessed to identify sarcopenia. The aim of this study was to determine the prognostic value of psoas muscle area measured with CT for the prediction of in-hospital mortality in patients with pulmonary embolism at admission to the intensive care unit. Methods. Patients with an admission abdominal computed tomography scan and requiring intensive care unit (ICU) stay were reviewed. Selected clinical data of patients admitted to intensive care unit for the management of pulmonary embolism were collected. Using CT scan images at the level of L3 vertebra, the psoas muscle area value was obtained by dividing the sum of the right and left psoas muscle areas into the body surface area. Results. In-hospital mortality rate was 22.5% in 89 patients. The pulmonary embolism patients with in-hospital mortality had higher PESI and lower value of psoas muscle area, in addition to the lower systolic blood pressure and arterial oxygen saturation at admission. The increase in the value of psoas muscle area is associated with a decrease in the rate of in-hospital mortality. In patients with in-hospital mortality related to pulmonary embolism, the higher PESI and the lower value of psoas muscle area were considered in accordance with the outcome of patients. Conclusions. For the prediction of in-hospital mortality risk in patients with pulmonary embolism managed in intensive care unit, the psoas muscle area value has a merit to be used among the routine diagnostic procedures after further studies conducted with different severity of pulmonary embolism.

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“…According to current guidelines, the patients are classified as high risk or non‐high risk based on the presence of hypotension or shock at presentation . For normotensive patients, Pulmonary Embolism Severity Index (PESI) score is a useful risk index to estimate the early mortality in patients with APE . In addition, previous studies demonstrated that some biomarkers—such as brain‐type natriuretic peptide and troponin I level—were useful for the prediction of early mortality in patients with APE …”

Section: Introductionmentioning

confidence: 99%

“…2 For normotensive patients, Pulmonary Embolism Severity Index (PESI) score is a useful risk index to estimate the early mortality in patients with APE. 4 In addition, previous studies demonstrated that some biomarkers-such as | 175 ÖZ et al…”

Section: Introductionmentioning

confidence: 99%

The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism

Öztaş¹,

Çınar²,

Hayıroğlu³

et al. 2019

Clinical Respiratory J

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Introduction and Objectives Prior studies demonstrated that plasma osmolality may have a predictive value for in‐hospital mortality in patients with heart failure and acute coronary syndrome. In addition, plasma glucose and blood urea nitrogen (BUN) levels, the components of plasma osmolality, have been shown to be an important contributor for in‐hospital mortality in acute pulmonary embolism (APE) patients. Hence, the objective of the current study is to evaluate the effect of plasma osmolality upon admission with in‐hospital mortality in patients with APE. Methods A total of 245 consecutive intermediate or high risk APE patients were enrolled into the study. The study population was divided into three tertile groups (T1, T2 and T3) based on the increased plasma osmolality. The in‐hospital mortality was the primary end‐point. Results After adjusting for all risk factors, in‐hospital mortality was significantly higher in the T3 group compared to T1 and T2 groups (OR: 3.6, 95% CI: 1.3 to 18.8, P < .001). In addition, the incidence of asystolia, hypotension and cardiogenic shock were significantly higher in the T3 group. An area under the receiver operating characteristic curve value of plasma osmolality for the in‐hospital mortality was 0.76 with sensitivity 67.2% and specificity 74.1% 95% CI: (0.66‐0.87, P < .001). Conclusion This is the first study to demonstrate that elevated levels of plasma osmolality may have a predictive value for in‐hospital mortality in APE patients. Our findings are novel and deserve further studies whether the treatment of higher plasma osmolality may reduce the risk of in‐hospital mortality in APE patients.

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The Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism

Cited by 24 publications

References 12 publications

Prognostic clinical prediction rules to identify a low‐risk pulmonary embolism: a systematic review and meta‐analysis

Prognostic clinical prediction rules to identify a low‐risk pulmonary embolism: a systematic review and meta‐analysis

Psoas Muscle Area Measured with Computed Tomography at Admission to Intensive Care Unit: Prediction of In-Hospital Mortality in Patients with Pulmonary Embolism

The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism

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