Comparing the pulmonary embolism severity index and the prognosis in pulmonary embolism scores as risk stratification tools.

Comparing the pulmonary embolism severity index and the prognosis in pulmonary embolism scores as risk stratification tools. - 2012

Available in print through MWHC library: 2007 only

BACKGROUND: Multiple risk stratification scoring systems exist to forecast outcomes in patients with acute pulmonary embolism (PE). CONCLUSIONS: The PREP score performed comparably to the PESI score for identifying PE patients at low risk for short-term and intermediate-term mortality.Copyright � 2011 Society of Hospital Medicine. DESIGN: Retrospective observational cohort study. INTERVENTION: The PESI and PREP scores were calculated. MEASUREMENTS: Raw PESI scores were segregated into risk class (I-V) and then dichotomized into low (I-II) versus high (III-V) risk groups; the raw PREP scores were divided into low (0-7) versus high (>7) risk groups. The primary endpoint was 30-day and 90-day mortality. We determined the negative predictive value and computed the area under the receiver operating characteristics (AUROC) curves to compare the ability of these scoring tools. OBJECTIVE: We evaluated the comparative validity of the PE severity index (PESI) and the prognosis in pulmonary embolism (PREP) scores to predict mortality in acute PE. PATIENTS: Consecutive adults (aged >18 years) diagnosed with acute PE. RESULTS: The cohort consisted of 302 subjects. Thirty-day mortality was 3.0%, and 4.0% died within 90 days. The PESI and the PREP performed similarly (PESI AUROC: 0.858 [95% confidence interval (CI), 0.773-0.943] vs 0.719 [95% CI, 0.563-0.875] for PREP). Segregating these scores into risk categories did not affect their discriminatory power (AUROC: 0.684 [95% CI, 0.559-0.810] for PESI and 0.790 [95% CI, 0.679-0.903] for PREP). The negative predictive value for death of being classified as low risk by the PESI or PREP was 100% and 99%, respectively. SETTING: Washington Hospital Center, Washington, DC.


English

1553-5592


*Pulmonary Embolism/di [Diagnosis]
*Pulmonary Embolism/mo [Mortality]
*Severity of Illness Index
Adult
Aged
Cohort Studies
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors


MedStar Washington Hospital Center


Medicine/Pulmonary-Critical Care


Comparative Study
Journal Article
Observational Study

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