Figures
- Figure 1–
Flow diagram of patient enrolment and outcomes. PE: pulmonary embolism; PESI: Pulmonary Embolism Severity Index; PESI48: Pulmonary Embolism Severity Index 48 h after admission; sPESI: simplified Pulmonary Embolism Severity Index.
Tables
- Table 1– The Pulmonary Embolism Severity Index (PESI)
Measure Score Patient age yrs Male patient +10 History of cancer +30 History of heart failure +10 History of chronic lung disease +10 Heart rate ≥110 beats·min−1 +20 Systolic blood pressure <100 mmHg +30 Respiratory rate ≥30 breaths·min−1 +20 Temperature <36°C/96.8°F +20 Altered mental status +60 O2 saturation <90% +20 The PESI risk score is calculated by starting with the patient’s age and adding additional points for any factors present as noted above. The patients are divided into five risk classes based upon the point total as follows: class I, <65 points; class II, 66–85 points; class III, 86–105 points; class IV, 106–125 points; class V, >126 points. Reproduced and modified from [5] with permission from the publisher.
- Table 2– The Simplified Pulmonary Embolism Severity Index
Age >80 yrs History of cancer History of heart failure or chronic lung disease Heart rate ≥110 beats·min−1 Systolic blood pressure <100 mmHg O2 saturation <90% Patients receive a point for each item present. Patients with 0 points are low risk and patients with ≥1 points are high risk. Reproduced and modified from [6] with permission from the publisher.
- Table 3– Baseline characteristics of 304 study patients
Patients n (%) Clinical characteristics Age >65 yrs 235 (77) Male 139 (46) Risk factors for VTE Cancer 63 (21) Surgery 27 (8.9) Immobility for ≥4 days 71 (23) Previous VTE 36 (12) Comorbid diseases Chronic lung disease 21 (6.9) Congestive heart failure 20 (6.6) Clinical presentation at admission Syncope 43 (14) Chest pain 120 (39) Dyspnoea 225 (74) Altered mental status 0 (0) Heart rate ≥110 beats·min−1 46 (15) Arterial oxyhaemoglobin saturation <90% 64 (21) Respiratory rate ≥30 breaths·min−1 19 (6.2) SBP <100 mmHg 5 (1.6) sPESI risk classes Low risk 54 (18) High risk 250 (82) Patients were classified as Pulmonary Embolism Severity Index (PESI) risk class III at the time of hospital admission. VTE: venous thromboembolism; SBP: systolic blood pressure; sPESI: simplified PESI.
- Table 4– Test characteristics of Pulmonary Embolism Severity Index 48 h after admission for predicting 30-day all-cause mortality and adverse outcomes
30-day mortality Adverse outcomes Sensitivity % 96.1 (88.8–100) 71.4 (38.0–100) Specificity % 29.5 (24.1–34.9) 27.3 (22.2–32.3) Positive predictive value % 11.3 (7.1–15.5) 2.3 (0.3–4.2) Negative predictive value % 98.8 (96.4–100) 97.6 (94.3–100) Positive likelihood ratio 1.4 (1.2–1.5) 1.0 (0.6–1.6) Negative likelihood ratio 0.1 (0.02–0.9) 1.0 (0.3–3.4) Data are presented with 95% confidence intervals.
- Table 5– Test characteristics of Simplified Pulmonary Embolism Severity Index 48 h after admission for predicting 30-day all-cause mortality and adverse outcomes
30-day mortality Adverse outcomes Sensitivity % 100 (100–100) 42.9 (6.2–79.5) Specificity % 30.2 (24.8–35.6) 26.9 (21.9–32.0) Positive predictive value % 11.8 (7.5–16.1) 1.4 (0–2.9) Negative predictive value % 100 (100–100) 95.2 (90.7–99.8) Positive likelihood ratio 1.4 (1.3–1.5) 0.6 (0.2–1.4) Negative likelihood ratio 0 2.1 (1.1–4.1) Data are presented with 95% confidence intervals.
