Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

被引：7

作者：

Jara-Palomares, Luis ^{[1
]}

Alfonso, Maria ^{[2
]}

Maestre, Ana ^{[3
]}

Jimenez, David ^{[4
]}

Garcia-Bragado, Fernando ^{[5
]}

Font, Carme ^{[6
]}

Lopez Reyes, Raquel ^{[7
]}

Hernandez Blasco, Luis ^{[8
]}

Vidal, Gemma ^{[9
]}

Otero, Remedios ^{[1
]}

Monreal, Manuel ^{[10
]}

Adarraga, Ma Dolores ^{[11
]}

Angel Aibar, Miguel ^{[12
]}

Aibar, Jesus ^{[13
]}

Amado, Cristina ^{[14
]}

Ignacio Arcelus, Juan ^{[15
]}

Ballaz, Aitor ^{[16
]}

Barba, Raquel ^{[17
]}

Barron, Manuel ^{[18
]}

Barron-Andres, Belen ^{[19
]}

Bascunana, Jose ^{[20
]}

Blanco-Molina, Angeles ^{[21
]}

Maria Camon, Ana ^{[12
]}

Canas, Inmaculada ^{[22
]}

Carrasco, Cristina ^{[23
]}

Castro, Joaquin ^{[24
]}

de Ancos, Cristina ^{[25
]}

Del Toro, Jorge ^{[26
]}

Demelo, Pablo ^{[26
]}

Antonio Diaz-Peromingo, Jose ^{[27
]}

Diaz-Simon, Raquel ^{[28
]}

Falga, Conxita ^{[29
]}

Isabel Farfan, Ana ^{[25
]}

Fernandez-Capitan, Carmen ^{[30
]}

Del Carmen Fernandez-Criado, Maria ^{[23
]}

Fernandez-Nunez, Sandra ^{[22
]}

Fidalgo, Angeles ^{[31
]}

Font, Llorenc ^{[32
]}

Angelina Garcia, Maria ^{[17
]}

Garcia-Morillo, Marcial ^{[6
]}

Garcia-Raso, Aranzzu ^{[33
]}

Gavin-Sebastian, Olga ^{[34
]}

del Carmen Gayol, Maria ^{[35
]}

Gil-Diaz, Aida ^{[36
]}

Gomez, Vicente ^{[37
]}

Gomez-Cuervo, Covadonga ^{[28
]}

Gonzalez-Martinez, Jose ^{[38
]}

Grau, Enric ^{[39
]}

Gutierrez, Javier ^{[40
]}

Gutierrez-Gonzalez, Sara ^{[41
]}

机构：

[1] Hosp Univ Virgen del Rocio, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Inst Biomed Sevilla IBiS, Dept Pneumonol,Med Surg Unit Resp Dis, Seville, Spain

[2] Complejo Hosp Navarra, Dept Pneumonol, Pamplona, Spain

[3] Hosp Univ Vinalopo, Dept Internal Med, Alicante, Spain

[4] Hosp Univ Ramon y Cajal, Resp Dept, IRYCIS, Madrid, Spain

[5] Hosp Univ Girona Dr Josep Trueta, Dept Internal Med, Girona, Spain

[6] Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain

[7] Hosp Univ & Politecn La Fe, Dept Pneumonol, Valencia, Spain

[8] Hosp Gen Univ Alicante, Dept Pneumonol, ISABIAL, Alicante, Spain

[9] Corp Sanitaria Parc Tauli, Dept Internal Med, Barcelona, Spain

[10] Univ Catolica Murcia, Hosp Univ Germans Trias & Pujol Badalona, Dept Internal Med, Murcia, Spain

[11] Hosp Montilla, Dept Internal Med, Cordoba, Spain

[12] Hosp Clin Univ Lozano Blesa, Dept Internal Med, Zaragoza, Spain

[13] Hosp Clin Barcelona, Dept Internal Med, Barcelona, Spain

[14] Hosp Sierrallana, Dept Internal Med, Santander, Spain

[15] Hosp Univ Virgen de las Nieves, Dept Gen Surg, Granada, Spain

[16] Hosp Galdakao, Dept Pneumonol, Vizcaya, Spain

[17] Hosp Rey Juan Carlos, Dept Internal Med, Madrid, Spain

[18] Complejo Hosp San Pedro, Dept Pneumonol, La Rioja, Spain

[19] Fdn Rioja Salud, Ctr Invest Biomed la Rioja, La Rioja, Spain

[20] Hosp Univ Infanta Leonor, Dept Internal Med, Madrid, Spain

[21] Hosp Univ Reina Sofia, Dept Internal Med, Cordoba, Spain

[22] Hosp Gen Granollers, Dept Internal Med, Barcelona, Spain

[23] Hosp Univ Virgen de Valme, Dept Pneumonol, Seville, Spain

[24] Hosp Santa Barbara, Dept Internal Med, Ciudad Real, Spain

[25] Hosp Univ Fuenlabrada, Dept Internal Med, Madrid, Spain

[26] Hosp Gen Univ Gregorio Maranon, Dept Internal Med, Madrid, Spain

[27] Hosp Clin Univ Santiago, Dept Internal Med, Santiago De Compostela, Spain

[28] Hosp Univ 12 Octubre, Dept Internal Med, Madrid, Spain

[29] Hosp Mataro, Dept Internal Med, Barcelona, Spain

[30] Hosp Univ La Paz, Dept Internal Med, Madrid, Spain

[31] Hosp Univ Salamanca, Dept Internal Med, Salamanca, Spain

[32] Hosp Tortosa Verge de la Cinta, Dept Haematol, Tarragona, Spain

[33] Hosp Univ Fdn Jimenez Diaz, Dept Haematol, Madrid, Spain

[34] Hosp Clin Univ Lozano Blesa, Dept Haematol, Zaragoza, Spain

[35] Hosp Comarcal de Barbanza, Dept Internal Med, La Coruna, Spain

[36] Hosp Univ Gran Canaria Dr Negrin, Dept Internal Med, Las Palmas Gran Canaria, Spain

[37] Hosp Univ Ramon y Cajal, Dept Pneumonol, Madrid, Spain

[38] Xarxa Assistencial Manresa, Dept Internal Med, ALTAHAIA, Barcelona, Spain

[39] Hosp Lluis Alcanyis, Dept Haematol & Hemotherapy, Valencia, Spain

[40] Univ Francisco de Vitoria, Hosp Monog ASEPEYO, Dept Internal Med, Madrid, Spain

[41] Hosp Clin Univ Valladolid, Dept Internal Med, Valladolid, Spain

[42] Hosp Cantoblanco, Dept Internal Med, Madrid, Spain

[43] Hosp Figueres, Dept Internal Med, Girona, Spain

[44] Hosp Univ Araba, Dept Pneumonol, Alava, Spain

[45] Hosp Gen Univ Albacete, Dept Pneumonol, Albacete, Spain

[46] Hosp Univ Puerto Real, Dept Internal Med, Cadiz, Spain

[47] Hosp Vega Baja de Orihuela, Dept Internal Med, Alicante, Spain

[48] Hosp Comarcal de Axarquia, Dept Internal Med, Malaga, Spain

[49] Hosp Univ Infanta Sofia, Dept Internal Med, Madrid, Spain

[50] Parc Sanitari St Joan de Deu Hosp Gen, Dept Internal Med & Emergency, Barcelona, Spain

来源：

SCIENTIFIC REPORTS | 2019年 / 9卷 / 1期

关键词：

VENOUS THROMBOEMBOLISM; ANTITHROMBOTIC THERAPY; CLINICAL PRESENTATION; PREDICTION; VALIDATION; OLDER; STRATIFICATION; DERIVATION; DIAGNOSIS; INDEX;

D O I：

10.1038/s41598-019-55213-8

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

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.

引用

页数：10

共 33 条

[1] A prediction rule to identify low-risk patients with pulmonary embolism [J].