BACKGROUND: The Pulmonary Embolism (PE) Severity Index (PESI) is a clinical prognostic rule that accurately classifies PE patients into 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: Five hundred and thirty-eight patients were enrolled in this study. The mean age was 70.6 years (± SD 15.2), 44.4% of patients were male, and 27.9% had known cancer. One-year follow-up was available for 96.1% of patients. The 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 to the original PESI at 3 and 6 months, but this was significantly lower at 1 year. CONCLUSIONS: The results of this study suggest that PESI score may also be an accurate tool to define the 6-month and 1-year mortality rates in PE patients.
BACKGROUND: The Pulmonary Embolism (PE) Severity Index (PESI) is a clinical prognostic rule that accurately classifies PE patients into 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: Five hundred and thirty-eight patients were enrolled in this study. The mean age was 70.6 years (± SD 15.2), 44.4% of patients were male, and 27.9% had known cancer. One-year follow-up was available for 96.1% of patients. The 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 to the original PESI at 3 and 6 months, but this was significantly lower at 1 year. CONCLUSIONS: The results of this study suggest that PESI score may also be an accurate tool to define the 6-month and 1-year mortality rates in PE patients.
Authors: Valdis Ģībietis; Dana Kigitoviča; Barbara Vītola; Sintija Strautmane; Andris Skride Journal: Med Princ Pract Date: 2019-02-04 Impact factor: 1.927
Authors: Phil Wells; W Frank Peacock; Gregory J Fermann; Craig I Coleman; Li Wang; Onur Baser; Jeff Schein; Concetta Crivera Journal: J Thromb Thrombolysis Date: 2019-07 Impact factor: 2.300
Authors: Li Wang; Onur Baser; Phil Wells; W Frank Peacock; Craig I Coleman; Gregory J Fermann; Jeff Schein; Concetta Crivera Journal: J Health Econ Outcomes Res Date: 2019-04-08
Authors: Ana Manuel; Adelina Aufico; Rui Africano; Tomáz Peralta; Abel Salas; Adelaide Silva; José Ricardo; Pedro Sabola; Domingas Baião; Carlos Sotolongo; António Dias Neto; Telmo Martins; Vasco Sabino; Joaquim van Dúnem; António Pedro Filipe Júnior Journal: Cardiovasc J Afr Date: 2017-05-17 Impact factor: 1.167
Authors: Li Wang; Onur Baser; Phil Wells; W Frank Peacock; Craig I Coleman; Gregory J Fermann; Jeff Schein; Concetta Crivera Journal: PLoS One Date: 2017-10-10 Impact factor: 3.240