Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism
Abstract Introduction Acute pulmonary embolism (APE) is a hazardous disorder with a high mortality. Combination of clinical, radiological, and serological parameters can improve risk stratification of APE. Most of the proposed combined scores were not validated in independent cohorts. Our aim was to...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-023-02489-0 |
| _version_ | 1797451754752704512 |
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| author | Alexey Surov Maximilian Thormann Caroline Bär Andreas Wienke Jan Borggrefe |
| author_facet | Alexey Surov Maximilian Thormann Caroline Bär Andreas Wienke Jan Borggrefe |
| author_sort | Alexey Surov |
| collection | DOAJ |
| description | Abstract Introduction Acute pulmonary embolism (APE) is a hazardous disorder with a high mortality. Combination of clinical, radiological, and serological parameters can improve risk stratification of APE. Most of the proposed combined scores were not validated in independent cohorts. Our aim was to validate the proposed clinical-radiological scores for prognosis of 7- and 30-day mortality in APE. Materials and methods Our sample comprised 531 patients with APE, mean age 64.8 ± 15.6 years, 221 (41.6%) females and 310 (58.4%) males. The following parameters were collected: Age and sex of the patients, mortality within the observation time of 30 days, simplified pulmonary embolism severity index (sPESI), pH troponin level (pg/ml), minimal systolic and diastolic blood pressures (mmHg), heart rate, O2 saturation, episodes of syncope, and need for vasopressors. On CT pulmonary angiography (CTPA), short axis ratio right ventricle/left ventricle (RV/LV), and reflux of contrast medium into the inferior vena cava were obtained. The following clinical-radiological scores were calculated: BOVA score, pulmonary embolism mortality score (PEMS), European Society of Cardiology (ESC) score, Kumamaru score, and Calgary acute pulmonary embolism (CAPE) score. Results Overall, 31 patients (5.8%) died within seven and 64 patients (12%) within 30 days. All scores showed high negative prognostic values ranging from 89.0 to 99.0%. PEMS and CAPE score demonstrated the highest specificity for 7-day mortality (93.4% and 85.0%), PEMS and BOVA for 30-day mortality (94.2% and 90.4%). The highest sensitivity was observed for ESC 2019 (96.8% and 95.3%). Kumamaru and CAPE scores had low sensitivity. All scores had low positive and high negative predictive values. Conclusion For prognosis of 7- and 30-day mortality in APE, PEMS score has the highest specificity. ESC 2019 shows the highest sensitivity. All scores had low positive and high negative predictive values. |
| first_indexed | 2024-03-09T14:58:58Z |
| format | Article |
| id | doaj.art-53b0ded7eddb4d79a9dfffa4bc3b2bf7 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-03-09T14:58:58Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-53b0ded7eddb4d79a9dfffa4bc3b2bf72023-11-26T14:01:55ZengBMCRespiratory Research1465-993X2023-08-012411810.1186/s12931-023-02489-0Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolismAlexey Surov0Maximilian Thormann1Caroline Bär2Andreas Wienke3Jan Borggrefe4Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University BochumDepartment of Radiology and Nuclear Medicine, Otto-von-Guericke University MagdeburgDepartment of Radiology and Nuclear Medicine, Otto-von-Guericke University MagdeburgInstitute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther- University Halle-WittenbergDepartment of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University BochumAbstract Introduction Acute pulmonary embolism (APE) is a hazardous disorder with a high mortality. Combination of clinical, radiological, and serological parameters can improve risk stratification of APE. Most of the proposed combined scores were not validated in independent cohorts. Our aim was to validate the proposed clinical-radiological scores for prognosis of 7- and 30-day mortality in APE. Materials and methods Our sample comprised 531 patients with APE, mean age 64.8 ± 15.6 years, 221 (41.6%) females and 310 (58.4%) males. The following parameters were collected: Age and sex of the patients, mortality within the observation time of 30 days, simplified pulmonary embolism severity index (sPESI), pH troponin level (pg/ml), minimal systolic and diastolic blood pressures (mmHg), heart rate, O2 saturation, episodes of syncope, and need for vasopressors. On CT pulmonary angiography (CTPA), short axis ratio right ventricle/left ventricle (RV/LV), and reflux of contrast medium into the inferior vena cava were obtained. The following clinical-radiological scores were calculated: BOVA score, pulmonary embolism mortality score (PEMS), European Society of Cardiology (ESC) score, Kumamaru score, and Calgary acute pulmonary embolism (CAPE) score. Results Overall, 31 patients (5.8%) died within seven and 64 patients (12%) within 30 days. All scores showed high negative prognostic values ranging from 89.0 to 99.0%. PEMS and CAPE score demonstrated the highest specificity for 7-day mortality (93.4% and 85.0%), PEMS and BOVA for 30-day mortality (94.2% and 90.4%). The highest sensitivity was observed for ESC 2019 (96.8% and 95.3%). Kumamaru and CAPE scores had low sensitivity. All scores had low positive and high negative predictive values. Conclusion For prognosis of 7- and 30-day mortality in APE, PEMS score has the highest specificity. ESC 2019 shows the highest sensitivity. All scores had low positive and high negative predictive values.https://doi.org/10.1186/s12931-023-02489-0Acute pulmonary embolismMortalityComputed tomography |
| spellingShingle | Alexey Surov Maximilian Thormann Caroline Bär Andreas Wienke Jan Borggrefe Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism Respiratory Research Acute pulmonary embolism Mortality Computed tomography |
| title | Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism |
| title_full | Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism |
| title_fullStr | Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism |
| title_full_unstemmed | Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism |
| title_short | Validation of clinical-radiological scores for prognosis of mortality in acute pulmonary embolism |
| title_sort | validation of clinical radiological scores for prognosis of mortality in acute pulmonary embolism |
| topic | Acute pulmonary embolism Mortality Computed tomography |
| url | https://doi.org/10.1186/s12931-023-02489-0 |
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