Titre
Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Jiménez, D.
Auteure/Auteur
Aujesky, D.
Auteure/Auteur
Moores, L.
Auteure/Auteur
Gómez, V.
Auteure/Auteur
Lobo, J.L.
Auteure/Auteur
Uresandi, F.
Auteure/Auteur
Otero, R.
Auteure/Auteur
Monreal, M.
Auteure/Auteur
Muriel, A.
Auteure/Auteur
Yusen, R.D.
Auteure/Auteur
Contributrices/contributeurs
Monreal, M.
Decousus, H.
Prandoni, P.
Brenner, B.
Barba, R.
Di Micco, P.
Rivron-Guillot, K.
Arcelus, JI.
Barrón, M.
Blanco, A.
Bonilla, M.
Bueso, T.
Cañas, I.
Casado, I.
Conget, F.
Falgá, C.
Fernández-Capitán, C.
Gallego, P.
García-Bragado, F.
Guijarro, R.
Grau, E.
Guil£££María£££ M.,
Gutiérrez, J.
Hernández£££Luís£££ L.,
Jiménez, D.
Lecumberri, R.
León, JM.
Llado£££María£££ M.,
Lobo, JL.
López, L.
Lorenzo, A.
Luque, JM.
Madridano, O.
Maestre, A.
Marchena, PJ.
Martín, A.
Martín-Villasclaras, JJ.
Monte, R.
Muñóz, FJ.
Naufall, MD.
Nieto, JA.
Oribe, M.
Orue£££María Teresa£££ MT.,
Otero, R.
Portillo, J.
Rabuñal£££Ramón£££ R.,
Renzi, C.
Riera-Mestre, A.
Rosa, V.
Rubio, S.
Ruiz-Gamietea, A.
Sahuquillo, JC.
Samperiz, AL.
Sánchez, R.
Sánchez Muñoz-Torrero JF.,
Sandoval£££Raúl£££ R.,
Soler, S.
Tiberio, G.
Tirado, R.
Todolí, JA.
Tolosa, C.
Torres, I.
Trujillo-Santos, J.
Uresandi, F.
Valdés, M.
Valdés£££Valentín£££ V.,
Valle, R.
Vasco, B.
Vela£££Jerónimo£££ J.,
Boccalon, H.
Falvo, N.
Le Corvoisier, P.
Rivron-Guillot, K.
Barillari, G.
Ciammaichella, M.
Dalla Valle, F.
Duce, R.
Ferrari, A.
Pasca, S.
Piovaccari, G.
Poggio, R.
Prandoni, P.
Quintavalla, R.
Rocci, A.
Rota, L.
Schenone, A.
Tiraferri, E.
Visonà, A.
Groupes de travail
RIETE Investigators
Liens vers les personnes
Liens vers les unités
ISSN
1538-3679
Statut éditorial
Publié
Date de publication
2010
Volume
170
Numéro
15
Première page
1383
Dernière page/numéro d’article
1389
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
BACKGROUND: The Pulmonary Embolism Severity Index (PESI) estimates the risk of 30-day mortality in patients with acute pulmonary embolism (PE). We constructed a simplified version of the PESI.
METHODS: The study retrospectively developed a simplified PESI clinical prediction rule for estimating the risk of 30-day mortality in a derivation cohort of Spanish outpatients. Simplified and original PESI performances were compared in the derivation cohort. The simplified PESI underwent retrospective external validation in an independent multinational cohort (Registro Informatizado de la Enfermedad Tromboembólica [RIETE] cohort) of outpatients.
RESULTS: In the derivation data set, univariate logistic regression of the original 11 PESI variables led to the removal of variables that did not reach statistical significance and subsequently produced the simplified PESI that contained the variables of age, cancer, chronic cardiopulmonary disease, heart rate, systolic blood pressure, and oxyhemoglobin saturation levels. The prognostic accuracy of the original and simplified PESI scores did not differ (area under the curve, 0.75 [95% confidence interval (CI), 0.69-0.80]). The 305 of 995 patients (30.7%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.0% (95% CI, 0.0%-2.1%) compared with 10.9% (8.5%-13.2%) in the high-risk group. In the RIETE validation cohort, 2569 of 7106 patients (36.2%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.1% (95% CI, 0.7%-1.5%) compared with 8.9% (8.1%-9.8%) in the high-risk group.
CONCLUSION: The simplified PESI has similar prognostic accuracy and clinical utility and greater ease of use compared with the original PESI.
METHODS: The study retrospectively developed a simplified PESI clinical prediction rule for estimating the risk of 30-day mortality in a derivation cohort of Spanish outpatients. Simplified and original PESI performances were compared in the derivation cohort. The simplified PESI underwent retrospective external validation in an independent multinational cohort (Registro Informatizado de la Enfermedad Tromboembólica [RIETE] cohort) of outpatients.
RESULTS: In the derivation data set, univariate logistic regression of the original 11 PESI variables led to the removal of variables that did not reach statistical significance and subsequently produced the simplified PESI that contained the variables of age, cancer, chronic cardiopulmonary disease, heart rate, systolic blood pressure, and oxyhemoglobin saturation levels. The prognostic accuracy of the original and simplified PESI scores did not differ (area under the curve, 0.75 [95% confidence interval (CI), 0.69-0.80]). The 305 of 995 patients (30.7%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.0% (95% CI, 0.0%-2.1%) compared with 10.9% (8.5%-13.2%) in the high-risk group. In the RIETE validation cohort, 2569 of 7106 patients (36.2%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.1% (95% CI, 0.7%-1.5%) compared with 8.9% (8.1%-9.8%) in the high-risk group.
CONCLUSION: The simplified PESI has similar prognostic accuracy and clinical utility and greater ease of use compared with the original PESI.
Sujets
PID Serval
serval:BIB_4F65B26A9994
PMID
Open Access
Oui
Date de création
2010-08-25T09:42:55.793Z
Date de création dans IRIS
2025-05-20T14:58:17Z