共 38 条
A New Index for the Prediction of 30-Day Mortality in Patients With Pulmonary Embolism: The Pulmonary Embolism Mortality Score (PEMS)
被引:23
作者:

Surov, Alexey
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机构:
Univ Leipzig, Dept Radiol, Leipzig, Germany
Otto von Guericke Univ, Dept Radiol & Nucl Med, Magdeburg, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Akritidou, Mideia
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机构:
Otto von Guericke Univ, Dept Internal Med, Magdeburg, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Bach, Andreas Gunther
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机构:
Martin Luther Univ Halle Wittenberg, Dept Radiol, Halle, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Bailis, Nikolaos
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机构:
Univ Leipzig, Dept Radiol, Leipzig, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Lerche, Marianne
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机构:
Univ Leipzig, Dept Resp Med, Leipzig, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Meyer, Hans Jonas
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机构:
Univ Leipzig, Dept Radiol, Leipzig, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Pech, Maciej
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机构:
Otto von Guericke Univ, Dept Radiol & Nucl Med, Magdeburg, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany

Wienke, Andreas
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h-index: 0
机构:
Martin Luther Univ Halle Wittenberg, Inst Med Epidemiol Biostat & Informat, Halle, Germany Univ Leipzig, Dept Radiol, Leipzig, Germany
机构:
[1] Univ Leipzig, Dept Radiol, Leipzig, Germany
[2] Otto von Guericke Univ, Dept Radiol & Nucl Med, Magdeburg, Germany
[3] Otto von Guericke Univ, Dept Internal Med, Magdeburg, Germany
[4] Martin Luther Univ Halle Wittenberg, Dept Radiol, Halle, Germany
[5] Univ Leipzig, Dept Resp Med, Leipzig, Germany
[6] Martin Luther Univ Halle Wittenberg, Inst Med Epidemiol Biostat & Informat, Halle, Germany
来源:
关键词:
acute pulmonary embolism;
30-day mortality;
simplified pulmonary embolism index;
computer tomographic pulmonary angiography;
D O I:
10.1177/0003319721993346
中图分类号:
R6 [外科学];
学科分类号:
1002 ;
100210 ;
摘要:
Our aim was to analyze possibility of combination of basic clinical and radiological signs to predict 30-day mortality after acute pulmonary embolism (PE). We included 486 patients. Age, gender, simplified pulmonary embolism index (sPESI), pH, troponin, N-terminal natriuretic peptide, minimal systolic and diastolic blood pressure, O-2 saturation, syncope, need for vasopressors, thrombotic obstruction, vessel diameter, short axis ratio right ventricle/left ventricle, and contrast medium reflux into the inferior vena cava (IVC) were analyzed. A backward algorithm in a logistic regression model was used to identify relevant risk factors. Multiple logistic regression analysis identified that sPESI, pH, minimal diastolic blood pressure, IVC reflux, and need for vasopressors influenced 30-day mortality. A score for mortality prediction was constructed (the Pulmonary Embolism Mortality Score): sPESI >2 points (1 point), pH <7.35 (1 point), minimal diastolic blood pressure <45 mm Hg (1 point), IVC reflux (1 point), and need for vasopressors (2 points). Patients with >3 points showed higher 30-day mortality (sensitivity: 84.9%, specificity: 83.0%, positive predictive value: 51.8%, negative predictive value: 96.2%). The net reclassification improvement compared with the sPESI was 0.94 (95% CI = 0.73-1.15). In conclusion, a new score can predict 30-day mortality in patients with PE and is more sensitive than sPESI.
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页码:787 / 793
页数:7
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