PT - JOURNAL ARTICLE AU - A. Sam AU - D. Sánchez AU - V. Gómez AU - C. Wagner AU - D. Kopecna AU - C. Zamarro AU - L. Moores AU - D. Aujesky AU - R. Yusen AU - D. Jiménez Castro TI - Usefulness of the shock index and the simplified pulmonary embolism severity index for identification of low-risk patientes with acute pulmonary embolism AID - 10.1183/09031936.00070110 DP - 2010 Jan 01 TA - European Respiratory Journal PG - erj00701-2010 4099 - http://erj.ersjournals.com/content/early/2010/07/22/09031936.00070110.short 4100 - http://erj.ersjournals.com/content/early/2010/07/22/09031936.00070110.full AB - 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.