Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism
Abstract Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is needed for proper management. Several prognostic models have been proposed. Aim The aim was to validate the original pulmonary embolism severity index (o-PESI) with its simplified version (s-PE...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-01-01
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| Series: | The Egyptian Journal of Bronchology |
| Subjects: | |
| Online Access: | https://doi.org/10.4103/ejb.ejb_68_19 |
| _version_ | 1818722879092555776 |
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| author | Maha Yousif Sabah A. Hussein |
| author_facet | Maha Yousif Sabah A. Hussein |
| author_sort | Maha Yousif |
| collection | DOAJ |
| description | Abstract Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is needed for proper management. Several prognostic models have been proposed. Aim The aim was to validate the original pulmonary embolism severity index (o-PESI) with its simplified version (s-PESI) and modified version (m-PESI) as predictors of in-hospital mortality and homeostatic morbidities (nonlethal repeated venous thromboembolism, and/or nonlethal serious hemorrhage) in patients with PE. Patients and methods Patients proved to have acute PE admitted to Menoufia and Cairo University Hospitals between March 2017 and March 2019 were included in the study. The o-PESI, s-PESI, and m-PESI were calculated for each patient. In-hospital mortality, homeostatic morbidities, and major adverse events (mortality and homeostatic morbidities) were registered. Results One hundred and two patients were recruited. Inhospital mortality rate was 13.7%, morbidity rate was 21.6%, whereas major adverse events rate was 31%. The s-PESI classified 31.4% of patients as low risk, and none of them had in-hospital mortality. The frequencies of major adverse events in the low-risk groups were 31.2, 9.1, and 75% for o-PESI, s-PESI, and m-PESI, respectively. Difference between adverse events and non-adverse events groups was significant when s-PESI was applied (P=0.008). The s-PESI had the highest sensitivity and negative predictive value in detecting mortality, morbidity, and major adverse events compared with o-PESI and m-PESI. The area under the curve for s-PESI was significantly above the other two indices (area under the curve=0.78, P=0.04). Conclusion In addition to its easy application, the s-PESI has a preferably superior prognostic accuracy than o-PESI and m-PESI in prognostication of low-risk patients with acute PE. |
| first_indexed | 2024-12-17T21:01:38Z |
| format | Article |
| id | doaj.art-937d86bf58ec49acb3e547bf9ce1d1b0 |
| institution | Directory Open Access Journal |
| issn | 1687-8426 2314-8551 |
| language | English |
| last_indexed | 2024-12-17T21:01:38Z |
| publishDate | 2020-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Bronchology |
| spelling | doaj.art-937d86bf58ec49acb3e547bf9ce1d1b02022-12-21T21:32:43ZengSpringerOpenThe Egyptian Journal of Bronchology1687-84262314-85512020-01-0113574775310.4103/ejb.ejb_68_19Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolismMaha Yousif0Sabah A. Hussein1Chest Department, Faculty of Medicine, Menoufia UniversityChest Department, Faculty of Medicine, Cairo UniversityAbstract Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is needed for proper management. Several prognostic models have been proposed. Aim The aim was to validate the original pulmonary embolism severity index (o-PESI) with its simplified version (s-PESI) and modified version (m-PESI) as predictors of in-hospital mortality and homeostatic morbidities (nonlethal repeated venous thromboembolism, and/or nonlethal serious hemorrhage) in patients with PE. Patients and methods Patients proved to have acute PE admitted to Menoufia and Cairo University Hospitals between March 2017 and March 2019 were included in the study. The o-PESI, s-PESI, and m-PESI were calculated for each patient. In-hospital mortality, homeostatic morbidities, and major adverse events (mortality and homeostatic morbidities) were registered. Results One hundred and two patients were recruited. Inhospital mortality rate was 13.7%, morbidity rate was 21.6%, whereas major adverse events rate was 31%. The s-PESI classified 31.4% of patients as low risk, and none of them had in-hospital mortality. The frequencies of major adverse events in the low-risk groups were 31.2, 9.1, and 75% for o-PESI, s-PESI, and m-PESI, respectively. Difference between adverse events and non-adverse events groups was significant when s-PESI was applied (P=0.008). The s-PESI had the highest sensitivity and negative predictive value in detecting mortality, morbidity, and major adverse events compared with o-PESI and m-PESI. The area under the curve for s-PESI was significantly above the other two indices (area under the curve=0.78, P=0.04). Conclusion In addition to its easy application, the s-PESI has a preferably superior prognostic accuracy than o-PESI and m-PESI in prognostication of low-risk patients with acute PE.https://doi.org/10.4103/ejb.ejb_68_19prognosispulmonary embolismrisk assessmentseverity index |
| spellingShingle | Maha Yousif Sabah A. Hussein Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism The Egyptian Journal of Bronchology prognosis pulmonary embolism risk assessment severity index |
| title | Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism |
| title_full | Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism |
| title_fullStr | Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism |
| title_full_unstemmed | Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism |
| title_short | Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism |
| title_sort | original simplified and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism |
| topic | prognosis pulmonary embolism risk assessment severity index |
| url | https://doi.org/10.4103/ejb.ejb_68_19 |
| work_keys_str_mv | AT mahayousif originalsimplifiedandmodifiedpulmonaryembolismseverityindicesinriskstratificationofpulmonaryembolism AT sabahahussein originalsimplifiedandmodifiedpulmonaryembolismseverityindicesinriskstratificationofpulmonaryembolism |