PT - JOURNAL ARTICLE AU - Lisa Moores AU - Celia Zamarro AU - Vicente Gómez AU - D. Aujesky AU - Leticia García AU - Rosa Nieto AU - R. Yusen AU - David Jiménez AU - on behalf of the IRYCIS Pulmonary Embolism Study Group TI - Changes in pesi score predict mortality in intermediate-risk patients with acute pe AID - 10.1183/09031936.00225011 DP - 2012 Jan 01 TA - European Respiratory Journal PG - erj02250-2011 4099 - http://erj.ersjournals.com/content/early/2012/07/11/09031936.00225011.short 4100 - http://erj.ersjournals.com/content/early/2012/07/11/09031936.00225011.full AB - Although the Pulmonary Embolism Severity Index (PESI) accurately identifies 35% of patients with acute pulmonary embolism (PE) as being low-risk, some patients deemed high-risk by the PESI on admission might be treated safely in the outpatient environment.This retrospective cohort study included a total of 304 consecutive patients with acute PE, classified at the time of hospital admission into PESI class III. The PESI was recalculated 48 hours after admission (PESI48) and reclassified each patient into the corresponding risk category. The primary outcome of the study was all-cause mortality between day 2 and day 30 after PE diagnosis.Twenty-six patients (8.5%; 95% CI, 5.4%–11.7%) died between day 2 and day 30 after PE diagnosis. Investigators reclassified 83 patients (27.3%; 95% CI, 22.3%–32.3%) as low-risk (classes I and II) at 48 hrs. Thirty-day mortality in these patients was 1.2% (95% CI 0%–3.5%) as opposed to 11.3% (95% CI, 7.1%–15.5%) in those who remained high risk. The net improvement in reclassification was estimated at 54% (P<0.001).In a cohort of intermediate-risk patients with acute PE, calculation of the PESI48 allows identification of those patients at very low risk of dying during the first month of follow-up.