Prediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score.

Jaquet, E; Tritschler, T; Stalder, O; Limacher, A; Méan, M; Rodondi, N; Aujesky, D (2018). Prediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score. Journal of thrombosis and haemostasis, 16(7), pp. 1313-1320. Wiley-Blackwell 10.1111/jth.14137

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INTRODUCTION The RIETE score was derived to identify patients with pulmonary embolism (PE) at low risk of overall complications. OBJECTIVE To externally validated the RIETE score and compared its prognostic performance to the Pulmonary Embolism Severity Index (PESI), its simplified version (sPESI), and the Geneva Prognostic Score (GPS). METHODS In a prospective multicenter cohort, we studied 687 elderly patients with acute PE. The primary outcome was 10-day overall complications (death, recurrent PE, or major bleeding), the secondary outcome was 30-day overall mortality. We compared complications and mortality in low- vs. higher-risk patients and the area under the receiver operating characteristic (ROC) curve across scores. RESULTS Overall, 27 patients (3.9%) had complications within 10 days and 22 (3.2%) died within 30 days. The RIETE score classified a smaller proportion of patients as low-risk (31%) than the PESI (35%), sPESI (36%), and the GPS (90%). The proportion of low-risk patients based on the RIETE score, PESI, sPESI, and GPS who had complications was 1.9%, 1.7%, 1.6%, and 2.9%, respectively. The RIETE score had a lower area under the ROC curve (0.60) for predicting complications than the PESI (0.67), sPESI (0.65), and GPS (0.72). The area under the ROC curve for predicting mortality was similar (0.76-0.78) for all scores. CONCLUSION The RIETE score classified fewer patients as low-risk than the other scores. It accurately identified patients at low mortality risk but was not superior to other scores in predicting 10-day overall complications. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Tritschler, Tobias; Stalder, Odile; Limacher, Andreas; Rodondi, Nicolas and Aujesky, Drahomir

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1538-7836

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

16 May 2018 15:01

Last Modified:

07 Feb 2019 12:59

Publisher DOI:

10.1111/jth.14137

PubMed ID:

29733493

Uncontrolled Keywords:

Elderly Mortality Prediction Prognosis Pulmonary embolism

BORIS DOI:

10.7892/boris.116535

URI:

https://boris.unibe.ch/id/eprint/116535

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