Comparing the pulmonary embolism severity index and the prognosis in pulmonary embolism scores as risk stratification tools.
Citation: Journal of Hospital Medicine (Online). 7(1):22-7, 2012 Jan.PMID: 22042764Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Observational StudySubject headings: *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 FactorsYear: 2012Local holdings: Available in print through MWHC library: 2007 onlyISSN:- 1553-5592
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 22042764 | Available | 22042764 |
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