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

Fecha de publicación: 27/12/2019

Autores de IIS La Fe

Raquel López Reyes

Autor

Participantes ajenos a IIS La Fe

Jara-Palomares L
Alfonso M
Maestre A
Jimenez D
Garcia-Bragado F
Font C
Blasco LH
Vidal G
Otero R
Monreal M
RIETE investigators

Grupos

Neumología

Leader

Miguel Ángel Martínez García

Abstract

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.

Datos de la publicación

ISSN/ISSNe:: 2045-2322, 2045-2322
Tipo:: Article
Páginas:: 20064-20064
DOI:: 10.1038/s41598-019-55213-8
Factor de Impacto:: 1,341 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

No hay documentos

Métricas

Filiaciones

Jara-Palomares L:: Department of Pneumonology, Medical Surgical Unit of Respiratory Diseases, Instituto de Biomedicina de Sevilla (IBiS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Hospital Universitario Virgen del Rocío, Seville, Spain.
Alfonso M:: Department of Pneumonology, Complejo Hospitalario de Navarra, Pamplona, Spain
Maestre A:: Department of Internal Medicine, Hospital Universitario de Vinalopó, Alicante, Spain
Jimenez D:: Respiratory Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
Garcia-Bragado F:: Department of Internal Medicine, Hospital Universitari de Girona Dr, Josep Trueta, Gerona, Spain
Font C:: Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
Reyes RL:: Department of Pneumonology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
Blasco LH:: Department of Pneumonology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
Vidal G:: Department of Internal Medicine, Corporación Sanitaria Parc Taulí, Barcelona, Spain
Otero R:: Department of Pneumonology, Medical Surgical Unit of Respiratory Diseases, Instituto de Biomedicina de Sevilla (IBiS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Hospital Universitario Virgen del Rocío, Seville, Spain
Monreal M:: Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Barcelona, Universidad Católica de Murcia, Murcia, Spain
RIETE investigators:: RIETE investigatorsesp