Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism

Moores, Lisa; Zamarro, Celia; Gómez, Vicente; Aujesky, Drahomir; García, Leticia; Nieto, Rosa; Yusen, Roger; Jiménez, David; Instituto Ramón y Cajal de Investigación Sanitaria Pulmonary Emb, (2013). Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism. European respiratory journal, 41(2), pp. 354-9. Sheffield, UK: European Respiratory Society 10.1183/09031936.00225011

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Although the Pulmonary Embolism Severity Index (PESI) accurately identifies 35% of patients with acute pulmonary embolism (PE) as being low risk, some patients deemed high risk by the PESI on admission might be treated safely in the outpatient environment. This retrospective cohort study included a total of 304 consecutive patients with acute PE, classified at the time of hospital admission into PESI class III. The PESI was recalculated 48 h after admission (PESI(48)) and each patient reclassified into the corresponding risk category. The primary outcome of the study was all-cause mortality between day 2 and day 30 after PE diagnosis. 26 (8.5%) patients (95% CI 5.4-11.7%) died between day 2 and day 30 after PE diagnosis. Investigators reclassified 83 (27.3%) patients (95% CI 22.3-32.3%) as low risk (classes I and II) at 48 h. 30-day mortality in these patients was 1.2% (95% CI 0-3.5%) as opposed to 11.3% (95% CI 7.1-15.5%) in those who remained high risk. The net improvement in reclassification was estimated at 54% (p<0.001). In a cohort of intermediate-risk patients with acute PE, calculation of the PESI(48) allows identification of those patients at very low risk of dying during the first month of follow-up.

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

UniBE Contributor:

Aujesky, Drahomir

ISSN:

0903-1936

Publisher:

European Respiratory Society

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:38

Last Modified:

17 Mar 2015 21:31

Publisher DOI:

10.1183/09031936.00225011

PubMed ID:

22743671

Web of Science ID:

000314624200017

URI:

https://boris.unibe.ch/id/eprint/15515 (FactScience: 222879)

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