Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis
Previous studies have suggested that Hestia criteria could effectively identifying patients with acute pulmonary embolism (PE) who were at low risk of mortality for outpatient treatment or early discharge. But the performance of Hestia criteria in stratifying patients at different risk class is stil...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-09-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296221126173 |
| _version_ | 1828242391460478976 |
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| author | Yubin Wang MM Yinhe Feng MD Rao Du MD Xiaoya Yang MM Jifeng Huang MM Hui Mao MD |
| author_facet | Yubin Wang MM Yinhe Feng MD Rao Du MD Xiaoya Yang MM Jifeng Huang MM Hui Mao MD |
| author_sort | Yubin Wang MM |
| collection | DOAJ |
| description | Previous studies have suggested that Hestia criteria could effectively identifying patients with acute pulmonary embolism (PE) who were at low risk of mortality for outpatient treatment or early discharge. But the performance of Hestia criteria in stratifying patients at different risk class is still unknown. We sought to comprehensively evaluate the prognostic impact of Hestia criteria for PE. The literatures search was conducted in PubMed, Web of Science and EMBASE from 1 August 2011 to 31 October 2021. Finally, Eight studies with 4110 patients were included in our meta-analysis. Overall, the pool percentage of patients classified as low-risk group and high-risk group were 41.4%% and 58.6% respectively, and the all-course mortality rates of each group were 2.3% and 10.6%, respectively. The pooled rate of PE-related composite adverse outcomes in high-risk group was increasingly higher than in low-risk group (15.7% vs 4.4%). High risk group was also markedly associated with overall mortality (OR: 7.21, 95%CI: 4.96-10.46, p < 0.00001), and PE-related adverse outcomes (OR:5.38, 95% CI:3.95-7.32, p < 0.00001). The pooled sensitivity, specificity, PLR, NLR of Hestia criteria for overall mortality were 0.90 (95% CI:0.83-0.94), 0.43 (95% CI:0.31-0.55), 1.6 (95% CI:1.3-1.9), 0.23 (95% CI: 0.15-0.35), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.77-0.84). The result of our meta-analysis indicate that Hestia criteria can effectively identify PE patients at low risk of poor prognosis with high sensitivity and NPV, but its prognostic role in patients with higher risk class still need to be verified. |
| first_indexed | 2024-04-12T22:14:42Z |
| format | Article |
| id | doaj.art-f251aa3171cb407591b890358617626f |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-04-12T22:14:42Z |
| publishDate | 2022-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-f251aa3171cb407591b890358617626f2022-12-22T03:14:35ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232022-09-012810.1177/10760296221126173Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-AnalysisYubin Wang MM0Yinhe Feng MD1Rao Du MD2Xiaoya Yang MM3Jifeng Huang MM4Hui Mao MD5 Department of Respiratory and Critical Care Medicine, , Chengdu 610041, Sichuan Province, China Department of Respiratory and Critical Care Medicine, People’s Hospital of Deyang City, Deyang 618000, Sichuan Province, China Department of Respiratory and Critical Care Medicine, , Chengdu 610041, Sichuan Province, China Department of Respiratory and Critical Care Medicine, , Chengdu 610041, Sichuan Province, China Department of Respiratory and Critical Care Medicine, , Chengdu 610041, Sichuan Province, China Department of Respiratory and Critical Care Medicine, , Chengdu 610041, Sichuan Province, ChinaPrevious studies have suggested that Hestia criteria could effectively identifying patients with acute pulmonary embolism (PE) who were at low risk of mortality for outpatient treatment or early discharge. But the performance of Hestia criteria in stratifying patients at different risk class is still unknown. We sought to comprehensively evaluate the prognostic impact of Hestia criteria for PE. The literatures search was conducted in PubMed, Web of Science and EMBASE from 1 August 2011 to 31 October 2021. Finally, Eight studies with 4110 patients were included in our meta-analysis. Overall, the pool percentage of patients classified as low-risk group and high-risk group were 41.4%% and 58.6% respectively, and the all-course mortality rates of each group were 2.3% and 10.6%, respectively. The pooled rate of PE-related composite adverse outcomes in high-risk group was increasingly higher than in low-risk group (15.7% vs 4.4%). High risk group was also markedly associated with overall mortality (OR: 7.21, 95%CI: 4.96-10.46, p < 0.00001), and PE-related adverse outcomes (OR:5.38, 95% CI:3.95-7.32, p < 0.00001). The pooled sensitivity, specificity, PLR, NLR of Hestia criteria for overall mortality were 0.90 (95% CI:0.83-0.94), 0.43 (95% CI:0.31-0.55), 1.6 (95% CI:1.3-1.9), 0.23 (95% CI: 0.15-0.35), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.77-0.84). The result of our meta-analysis indicate that Hestia criteria can effectively identify PE patients at low risk of poor prognosis with high sensitivity and NPV, but its prognostic role in patients with higher risk class still need to be verified.https://doi.org/10.1177/10760296221126173 |
| spellingShingle | Yubin Wang MM Yinhe Feng MD Rao Du MD Xiaoya Yang MM Jifeng Huang MM Hui Mao MD Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis Clinical and Applied Thrombosis/Hemostasis |
| title | Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis |
| title_full | Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis |
| title_fullStr | Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis |
| title_short | Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis |
| title_sort | prognostic performance of hestia criteria in acute pulmonary embolism a systematic review and meta analysis |
| url | https://doi.org/10.1177/10760296221126173 |
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