The shock index and the simplified PESI for identification of low-risk patients with acute pulmonary embolism

Sam, A; Sánchez, D; Gómez, V; Wagner, C; Kopecna, D; Zamarro, C; Moores, L; Aujesky, D; Yusen, R; Jiménez Castro, D (2011). The shock index and the simplified PESI for identification of low-risk patients with acute pulmonary embolism. European respiratory journal, 37(4), pp. 762-6. Sheffield, UK: European Respiratory Society 10.1183/09031936.00070110

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We compared the test characteristics of the shock index (SI) and the simplified pulmonary embolism severity index (sPESI) for predicting 30-day outcomes in a cohort of 1,206 patients with objectively confirmed pulmonary embolism (PE). The primary outcome of the study was all-cause mortality. The secondary outcome was nonfatal symptomatic recurrent venous thromboembolism (VTE) or nonfatal major bleeding. Overall, 119 (9.9%) out of 1,206 patients died (95% CI 8.2-11.5%) during the first month of follow-up. The sPESI classified fewer patients as low-risk (369 (31%) out of 1,206 patients, 95% CI 28-33%) compared to the SI (1,024 (85%) out of 1,206 patients, 95% CI 83-87%) (p<0.001). Low-risk patients based on the sPESI had a lower 30-day mortality than those based on the SI (1.6% (95% CI 0.3-2.9%) versus 8.3% (95% CI 6.6-10.0%)), while the 30-day rate of nonfatal recurrent VTE or major bleeding was similar (2.2% (95%CI 0.7-3.6%) versus 3.3% (95%CI 2.2-4.4%)). The net reclassification improvement with the sPESI was 13.4% (p = 0.07). The integrated discrimination improvement was estimated as 1.8% (p<0.001). The sPESI quantified the prognosis of patients with PE better than the SI.

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 14:11

Last Modified:

04 May 2014 23:05

Publisher DOI:

10.1183/09031936.00070110

PubMed ID:

20650994

Web of Science ID:

000289055300010

URI:

https://boris.unibe.ch/id/eprint/2213 (FactScience: 204507)

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