[Comparative evaluation of prognostic scores in pulmonary embolism ].
OBJECTIVE
Pulmonary embolism is a life threatening disease and one of the main causes of in-hospital mortality. There are multiple risk stratification scoring systems for the forecast of the outcomes in patients with pulmonary embolism.


METHODS
We conducted a prospective observational cohort study to evaluate the comparative validity of four prognostic models: pulmonary embolism severity index (PESI), simplified PESI score, PESI risk classes and shock index, for predicting short-term mortality in acute pulmonary embolism. The PESI and PESI--simplified scores and shock-index were calculated. PESI scores were segregated into risk class (I-V) obtaining PESI classes. Shock index was dichotomized into 0 (for value < 1) versus 1 (for value > 1) risk groups. We determined the area under Receiver Operating Characteristic curve, the sensitivity, specificity, likelihood ratio (LR+, LR-) for PESI score, simplified PESI score, PESI risk classes and shock index, to compare the ability of these scoring tools.


RESULTS
The cohort consisted of 362 subjects. The mortality was 21.54%. The sensitivity, specificity and likelihood ratios were different between scores but the area under Receiver Operating Characteristic curve showed values in range 0.6-0.7.


CONCLUSIONS
The assessed prognostic scores performed comparably for identifying pulmonary embolism patients at short-term risk of mortality, even for PESI score segregated in risk classes and dichotomized version of shock index.
Universităţii de Medicină si Farmacie "Grigore T. Popa", Iaşi.
Iulia-Cristina
IC
Roca
Viviana
V
Aursulesei
M
M
Roca
M D
MD
Datcu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate