Pulmonary Embolism Severity Index Accurately Predicts Long-Term Mortality Rate In Patients Hospitalized For Acute Pulmonary Embolism.
J Thromb Haemost. 2013 Oct 1;
Authors: Dentali F, Riva N, Turato S, Grazioli S, Squizzato A, Steidl L, Guasti L, Grandi AM, Ageno W
Abstract
BACKGROUND: The Pulmonary Embolism (PE) Severity Index (PESI) is a clinical prognostic rule that accurately classifies PE patients in five risk classes with increasing mortality. PESI score has been validated in studies with a relatively short-term follow-up and its accuracy in predicting long-term prognosis has never been established.
METHODS: Consecutive patients admitted to the tertiary care hospital of Varese (Italy) with an objectively diagnosed PE between January 2005 and December 2009 were retrospectively included. Information on clinical presentation, diagnostic work-up, risk factors, treatment, and mortality during a 1-year follow-up was collected.
RESULTS: 538 patients were enrolled in this study. Mean age was 70.6 (± SD 15.2), 44.4% of patients were males, and 27.9% had known cancer. One-year follow up was available for 96.1% of patients. Overall mortality rate was 23.2% at 3 months, 30.2% at 6 months and 37.1% at 12 months. The discriminatory power of the PESI score to predict long-term mortality, expressed as the area under the ROC curve, was 0.77 (95%CI 0.72-0.81) at 3 months, 0.77 (95%CI 0.73-0.81) at 6 months and 0.79 (95%CI 0.75-0.82) at 12 months. The PESI score confirmed its accurate prediction in patients without cancer. Simplified PESI had a similar overall accuracy compared to the original PESI at 3 and 6 months, but this was significantly lower at one year.
CONCLUSIONS: The results of this study suggest that PESI score may also be an accurate tool to define the 6-month and one-year mortality rates in PE patients. This article is protected by copyright. All rights reserved.
PMID: 24119089 [PubMed - as supplied by publisher]