Comparing the pulmonary embolism severity index and the prognosis in pulmonary embolism scores as risk stratification tools
Chan, Chee Man
Shorr, Andrew F
Woods, Christian J
text
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2012
monographic
en
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.
Available in print through MWHC library: 2007 only
English
*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
1553-5592
http://dx.doi.org/10.1002/jhm.932
http://dx.doi.org/10.1002/jhm.932
Ovid MEDLINE(R)
160113