Aims: We ascertain less than 7-day mortality data in suspected pulmonary embolism (PE) in order to risk stratify patients suitable for outpatient imaging.
Methods: Retrospective identification of patients presenting to two emergency departments over a two-year period, with a radiologically confirmed PE. PESI and sPESI scores correlated with death at 1, 3, 7, 30 and 90 days.
Results: There was significant correlation between all PESI risk classes and death at 3, 7, 30 and 90 days (p<0.01), but not day 1. No deaths occurred within 1 and 3 days in low risk PESI groups or within 90 days in the low risk sPESI.
Conclusion: PESI/sPESI could be reliably utilized to risk stratify patients being considered for outpatient investigation of PE.
[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]
References
- Roy PM, Corsi DJ, Carrier M, et al; Net clinical benefit of hospitalization versus outpatient management of patients with acute pulmonary embolism. J Thromb Haemost. 2017; 15(4): 685-694
- Vali Y, Ladwa R, Bailie E, et al; Investigating and managing suspected pulmonary embolism in an outpatient setting: the Leicester experience. Thorax 2015; 70(3): 291-293
- Howard L, Barden S, Condliffe R, et al; British Thoracic Society Guideline for the initial outpatient management of pulmonary embolism (PE). Thorax 2018; 73(2): 1-29.
- Aujesky D, Obrosky DS, Stone RA, et al; Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005; 72(8): 1041-1046.
- Donzé J, LeGal G, Fine MJ, et al; Prospective validation of the Pulmonary Embolism Severity Index. A clinical prognostic model for pulmonary embolism. Thromb Haemost, 2008; 100(5): 943-948.
- Aujesky D, Roy PM, Verschuren F, et al; Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. Lancet 2011; 378(9785): 41-48
- Jiménez D, Aujesky D, Moores L, et al; Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients with Acute Symptomatic Pulmonary Embolism. Arch Intern Med 2010; 70(15): 1383-1389
- Squizzato A, Donadini MP, Galli L, et al; Prognostic clinical prediction rules to identify a low-risk pulmonary embolism: a systemaic review and meta-analysis. J Thromb Haemost 2012; 10(7):1276-1290
- Reschen ME, Raby J, Bowen J, et al; A retrospective analysis of outcomes in low- and intermediate–high-risk pulmonary embolism patients managed on an ambulatory medical unit in the UK. ERJ Open Res 2019; 5: 00184-2018
- Zhou XY, Ben SQ, Chen HL; The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a metaanalysis. Respir Res. 2012; 13(1): 111
Request Permissions
To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:
