Yizhuo Gao1, Chao Ji2, Hongyu Zhao3, Jun Han3, Haitao Shen3, Dong Jia4. 1. Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, China. 2. Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, China. 3. Department of Emergency Medicine, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, China. 4. Department of Emergency Medicine, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, China. jiadong0101@126.com.
Abstract
BACKGROUND: It is important to identify deterioration in normotensive patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission. METHODS: Clinical, laboratory, and computed tomography parameters were retrospectively collected for normotensive patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into the hospital. The endpoint of the deterioration was any adverse outcome within 30 days. Eligible patients were randomized 2:1 to derivation and validation cohorts, and a nomogram was developed and validated by the aforementioned cohorts, respectively. The areas under the curves (AUCs) with 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator. RESULTS: The 845 eligible patients (420 men, 425 women) had an average age of 60.05 ± 15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricle/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the derivation cohort (95% CI 0.900-0.946, p < 0.001) and 0.900 in the validation cohort (95% CI 0.883-0.948, p < 0.001). A risk-scoring tool was published as a web-based calculator ( https://gaoyzcmu.shinyapps.io/APE9AD/ ). CONCLUSIONS: We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.
BACKGROUND: It is important to identify deterioration in normotensive patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission. METHODS: Clinical, laboratory, and computed tomography parameters were retrospectively collected for normotensive patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into the hospital. The endpoint of the deterioration was any adverse outcome within 30 days. Eligible patients were randomized 2:1 to derivation and validation cohorts, and a nomogram was developed and validated by the aforementioned cohorts, respectively. The areas under the curves (AUCs) with 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator. RESULTS: The 845 eligible patients (420 men, 425 women) had an average age of 60.05 ± 15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricle/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the derivation cohort (95% CI 0.900-0.946, p < 0.001) and 0.900 in the validation cohort (95% CI 0.883-0.948, p < 0.001). A risk-scoring tool was published as a web-based calculator ( https://gaoyzcmu.shinyapps.io/APE9AD/ ). CONCLUSIONS: We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.
Entities:
Keywords:
Computerized tomography; Nomogram; Pulmonary embolism; Right ventricle
Authors: Maria Cristina Vedovati; Ludovica Anna Cimini; Lucia Pierpaoli; Simone Vanni; Marilena Cotugno; Piotr Pruszczyk; Francesco Di Filippo; Valerio Stefanone; Leticia Guirado Torrecillas; Marta Kozlowska; Maria Grazia De Natale; Federica Mannucci; Giancarlo Agnelli; Cecilia Becattini Journal: Eur Heart J Acute Cardiovasc Care Date: 2020-03-13