PT - JOURNAL ARTICLE AU - Lukas Hobohm AU - Kristian Hellenkamp AU - Gerd Hasenfuß AU - Thomas Münzel AU - Stavros Konstantinides AU - Mareike Lankeit TI - Comparison of risk assessment strategies for not-high-risk pulmonary embolism AID - 10.1183/13993003.01605-2015 DP - 2016 Apr 01 TA - European Respiratory Journal PG - 1170--1178 VI - 47 IP - 4 4099 - http://erj.ersjournals.com/content/47/4/1170.short 4100 - http://erj.ersjournals.com/content/47/4/1170.full SO - Eur Respir J2016 Apr 01; 47 AB - We compared the prognostic performance of the 2014 European Society of Cardiology (ESC) risk stratification algorithm with the previous 2008 ESC algorithm, the Bova score and the modified FAST score (based on a positive heart-type fatty acid-binding protein (H-FABP) test, syncope and tachycardia, modified using high-sensitivity troponin T instead of H-FABP) in 388 normotensive pulmonary embolism patients included in a single-centre cohort study.Overall, 25 patients (6.4%) had an adverse 30-day outcome. Regardless of the score or algorithm used, the rate of an adverse outcome was highest in the intermediate-high-risk classes, while all patients classified as low-risk had a favourable outcome (no pulmonary embolism-related deaths, 0–1.4% adverse outcome). The area under the curve for predicting an adverse outcome was higher for the 2014 ESC algorithm (0.76, 95% CI 0.68–0.84) compared with the 2008 ESC algorithm (0.65, 95% CI 0.56–0.73) and highest for the modified FAST score (0.82, 95% CI 0.75–0.89). Patients classified as intermediate-high-risk by the 2014 ESC algorithm had a 8.9-fold increased risk for an adverse outcome (3.2–24.2, p<0.001 compared with intermediate-low- and low-risk patients), while the highest OR was observed for a modified FAST score ≥3 points (OR 15.9, 95% CI 5.3–47.6, p<0.001).The 2014 ESC algorithm improves risk stratification of not-high-risk pulmonary embolism compared with the 2008 ESC algorithm. All scores and algorithms accurately identified low-risk patients, while the modified FAST score appears more suitable to identify intermediate-high-risk patients.2014 ESC guideline algorithm improves risk stratification of not-high-risk PE compared with 2008 ESC algorithm http://ow.ly/UT0K6