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

 -  2012 
<br/><br/>Available in print through MWHC library: 2007 only 
<br/><br/> 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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1553-5592 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Pulmonary Embolism/di [Diagnosis]<br/>*Pulmonary Embolism/mo [Mortality]<br/>*Severity of Illness Index<br/>Adult<br/>Aged<br/>Cohort Studies<br/>Female<br/>Humans<br/>Male<br/>Middle Aged<br/>Predictive Value of Tests<br/>Prognosis<br/>Retrospective Studies<br/>Risk Factors
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Medicine/Pulmonary-Critical Care
<br/><br/><label>Index Terms--Function: </label><br/>Comparative Study<br/>Journal Article<br/>Observational Study