Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged
Jara-Palomares, L.; Alfonso, M.; Maestre, A.; Jimenez, D.; Garcia-Bragado, F.; Font, C.; Reyes, R. L.; Blasco, L. H.; Vidal, G.; Otero, R.; Monreal, M.; Adarraga, M. ªD; Aibar, M. Á; Aibar, J.; Amado, C.; Arcelus, J. I.; Ballaz, A.; Barba, R.; Barrón, M.; Barrón-Andrés, B.; Bascuñana, J.; Blanco-Molina, Á; Camón, A. M.; Cañas, I.; Carrasco, C.; Castro, J.; de Ancos, C.; Del Toro, J.; Demelo, P.; Díaz Peromingo, José Antonio; Díaz-Simón, R.; Falgá, C.; Farfán, A. I.; Fernández-Capitán, C.; del Carmen Fernández-Criado, M.; Fernández-Núñez, S.; Fidalgo, Á; Font, L.; García, M. A.; García-Morillo, M.; García-Raso, A.; Gavín-Sebastián, O.; Gayol Fernández, María del Carmen; Gil-Díaz, A.; Gómez, V.; Gómez-Cuervo, C.; González-Martínez, J.; Grau, E.; Gutiérrez, J.; Gutiérrez-González, S.; Iglesias, M.; Jaras, M. ªJ; Jou, I.; Joya, M. D.; Lalueza, A.; Lima, J.; Llamas, P.; Lobo, J. L.; López-Jiménez, L.; López-Miguel, P.; López-Núñez, J. J.; López-Sáez, J. B.; Lorente, M. A.; Lorenzo, A.; Loring, M.; Madridano, O.; Marchena, P. J.; Martín, J. M.; Mellado, M.; Morales, M. ªV; Nieto, M. L.; Nieto, J. A.; Núñez, M. J.; Olivares, M. C.; Pedrajas, J. M.; Pellejero, G.; Pérez-Rus, G.; Peris, M. ªL; Porras, J. A.; Rivas, A.; Rodríguez-Dávila, M. ªÁ; Adela Rodríguez-Hernández, A.; Rubio, C. M.; Ruiz-Artacho, P.; Ruiz-Ruiz, J.; Ruiz-Sada, P.; Sahuquillo, J. C.; Salazar, V.; Sampériz, Á; Muñoz-Torrero, J. F. S.; Sancho, T.; Soler, S.; Suriñach, J. M.; Tapia, E.; Tolosa, C.; Torres, M. I.; Trujillo-Santos, J.; Uresandi, F.; Valle, R.; Villares, P.; Gutiérrez, P.; Vázquez, F. J.; Vilaseca, A.; Vanassche, T.; Vandenbriele, C.; Verhamme, P.; Hirmerova, J.; Malý, R.; Celis, G.; del Pozo, G.; Salgado, E.; Benzidia, I.; Bertoletti, L.; Bura-Riviere, A.; Debourdeau, P.; Farge-Bancel, D.; Hij, A.; Mahé, I.; Moustafa, F.; Schellong, S.; Braester, A.; Brenner, B.; Tzoran, I.; Sharif-Kashani, B.; Barillari, G.; Bilora, F.; Bortoluzzi, C.; Brandolin, B.; Bucherini, E.; Ciammaichella, M.; Dentali, F.; Di Micco, P.; Maida, R.; Mastroiacovo, D.; Mumoli, N.; Pace, F.; Parisi, R.; Pesavento, R.; Prandoni, P.; Quintavalla, R.; Rocci, A.; Romualdi, R.; Sinicalchi, C.; Tufano, A.; Visonà, A.; Hong, N. V.; Zalunardo, B.; Gibietis, V.; Kigitovica, D.; Skride, A.; Bosevski, M.; Bounameaux, H.; Mazzolai, L.; Caprini, J. A.; Bui, H. M.; Pham, K. Q.; Reis, A.
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Identificadores
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Autor corporativo
Riete investigatorsFecha de publicación
2019Título de revista
Scientific Reports
Tipo de contenido
Artigo
DeCS
pronóstico | factores de riesgo | estudios retrospectivos | mediana edad | humanos | embolia pulmonarMeSH
Risk Factors | Middle Aged | Humans | Pulmonary Embolism | Retrospective Studies | PrognosisResumen
In young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged <50 years. We used the RIETE database, including PE patients from 2001 to 2017. The major outcome was 30-day all-cause mortality. Of 34,651 patients with acute PE, 5,822 (17%) were aged <50 years. Of these, 83 (1.4%) died during the first 30 days. Number of patients deemed low risk with tools was: PREP (95.9%), GPS (89.6%), PESI (87.2%), Shock index (70.9%), sPESI (59.4%), Prognostic algorithm (58%) and RIETE score (48.6%). The tools with a highest sensitivity were: Prognostic Algorithm (91.6%; 95% CI: 85.6-97.5), RIETE score (90.4%; 95%CI: 84.0-96.7) and sPESI (88%; 95% CI: 81-95). The RIETE, Prognostic Algorithm and sPESI scores obtained the highest overall sensitivity estimates for also predicting 7- and 90-day all-cause mortality, 30-day PE-related mortality, 30-day major bleeding and 30-day VTE recurrences. The proportion of low-risk patients who died within the first 30 days was lowest using the Prognostic Algorithm (0.2%), RIETE (0.3%) or sPESI (0.3%) scores. In PE patients less 50 years, 30-day mortality was low. Although sPESI, RIETE and Prognostic Algorithm scores were the most sensitive tools to identify patients at low risk to die, other tools should be evaluated in this population to obtain more efficient results.
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