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Usefulness of the shock index and the simplified pulmonary embolism severity index for identification of low-risk patientes with acute pulmonary embolism

A. Sam, D. Sánchez, V. Gómez, C. Wagner, D. Kopecna, C. Zamarro, L. Moores, D. Aujesky, R. Yusen, D. Jiménez Castro
European Respiratory Journal 2010; DOI: 10.1183/09031936.00070110
A. Sam
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D. Sánchez
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V. Gómez
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C. Wagner
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D. Kopecna
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C. Zamarro
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L. Moores
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D. Aujesky
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R. Yusen
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D. Jiménez Castro
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Abstract

We compared the test characteristics of the Shock Index (SI) and the simplified Pulmonary Embolism Severity Index (sPESI) for predicting 30-day outcomes in a cohort of 1,206 patients with objectively confirmed pulmonary embolism (PE). The primary outcome of the study was all-cause mortality. The secondary outcome was non fatal symptomatic recurrent VTE or non fatal major bleeding. Overall, 119 out of 1,206 patients died (9.9%; 95% confidence interval [CI], 8.2% to 11.5%) during the first month of follow-up. The sPESI classified fewer patients as low risk (31% [369/1,206], 95% CI: 28% to 33%) compared to the SI (85% [1,024/1,206], 95% CI: 83% to 87%) (P<0.001). Low-risk patients based on the sPESI had a lower 30-day mortality than those based on the SI (1.6% [95% CI, 0.3–2.9] versus 8.3% [95% CI, 6.6–10.0]), while the 30-day rate of non fatal recurrent VTE or major bleeding was similar (2.2% [95%CI, 0.7% to 3.6%] versus 3.3% [95%CI, 2.2% to 4.4%]). The net reclassification improvement with the sPESI was 13.4% (P=0.07). The integrated discrimination improvement was estimated as 1.8% (P<0.001). The sPESI quantified the prognosis of patients with PE better than the SI.

  • Lung
  • prognosis
  • pulmonary embolism
  • thrombosis
  • ERS
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Usefulness of the shock index and the simplified pulmonary embolism severity index for identification of low-risk patientes with acute pulmonary embolism
A. Sam, D. Sánchez, V. Gómez, C. Wagner, D. Kopecna, C. Zamarro, L. Moores, D. Aujesky, R. Yusen, D. Jiménez Castro
European Respiratory Journal Jan 2010, erj00701-2010; DOI: 10.1183/09031936.00070110

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Usefulness of the shock index and the simplified pulmonary embolism severity index for identification of low-risk patientes with acute pulmonary embolism
A. Sam, D. Sánchez, V. Gómez, C. Wagner, D. Kopecna, C. Zamarro, L. Moores, D. Aujesky, R. Yusen, D. Jiménez Castro
European Respiratory Journal Jan 2010, erj00701-2010; DOI: 10.1183/09031936.00070110
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