Savas Ozsu1, Tevfik Ozlu2, Ayşegül Sentürk3, Elif Yılmazel Uçar4, Gamze Kırkıl5, Esra Ekbiç Kadıoğlu6, Bülent Altınsoy7, Bengü Saylan8, Hatice Şen Selimoğlu9, Gül Dabak10, Nuri Tutar11, Ahmet Uysal12. 1. Karadeniz Technical University, School of Medicine, Department of Pulmonary Medicine, Trabzon, Turkey. Electronic address: savasozsu@gmail.com. 2. Karadeniz Technical University, School of Medicine, Department of Pulmonary Medicine, Trabzon, Turkey. Electronic address: ozlutevfik@yahoo.com. 3. Ankara Atatürk Training and Research Hospital, Department of Pulmonary Medicine, Ankara,Turkey. Electronic address: asenturk1967@yahoo.com. 4. Atatürk University School of Medicine, Department of Pulmonary Medicine, Erzurum, Turkey. Electronic address: eucar1979@yahoo.com. 5. Fırat University School of Medicine, Department of Chest, Pulmonary Medicine, Turkey. Electronic address: gamkirkil@yahoo.com. 6. Erzurum Regional Training and Research Hospital, Department of Pulmonary Medicine, Erzurum, Turkey. Electronic address: esraekbic@hotmail.com. 7. Bülent Ecevit University School of Medicine, Department of Pulmonary Medicine, Zonguldak, Turkey. Electronic address: balt1907@yahoo.com. 8. Ümraniye Training and Research Hospital, Department of Pulmonary Medicine, İstanbul, Turkey. Electronic address: metebengu@yahoo.com. 9. Dicle University School of Medicine, Department of Pulmonary Medicine, Diyarbakır, Turkey. Electronic address: dr.haticesen@hotmail.com. 10. Koşuyolu Training and Research Hospital, Department of Pulmonary Medicine, İstanbul, Turkey. Electronic address: dgrdabak@hotmail.com. 11. Erciyes University School of Medicine, Department of Pulmonary Medicine, Kayseri, Turkey. Electronic address: drnuritutar@gmail.com. 12. Ege University School of Medicine, Department of Pulmonary Medicine, İzmir, Turkey. Electronic address: ahmet-bh@hotmail.com.
Abstract
BACKGROUND: Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. METHODS: This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding. RESULTS: Of the 1078 study patients, 95 (8.8%) died within 30days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P=NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%. CONCLUSIONS: The sPESI and the ESC model showed a similar performance regarding 30-day mortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE.
BACKGROUND: Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. METHODS: This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding. RESULTS: Of the 1078 study patients, 95 (8.8%) died within 30days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P=NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%. CONCLUSIONS: The sPESI and the ESC model showed a similar performance regarding 30-day mortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE.
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: PLoS One Date: 2017-10-10 Impact factor: 3.240