title: Prognostic role of the simplified pulmonary embolism severity index and shock index in pulmonary embolism.
abstract: BACKGROUND
  The stratification of acute pulmonary embolism (PE) using the simplified pulmonary embolism severity index (sPESI) and shock index (SI) does not require any prognostic tools such as biomarkers or echocardiography.
  
  
  OBJECTIVE
  We compared the ability of the sPESI and SI to predict 30-day and 3-year mortality following PE.
  
  
  METHODS
  Prognostic models based on the sPESI and SI were used to predict the overall 30-day (short-term) and 3-year (long-term) mortality in a cohort of 194 patients with confirmed PE.
  
  
  RESULTS
  Overall, the mortality rate in this cohort was 9.2% in the first month and 29.9% at 3 years. The sPESI categorized fewer patients as low risk (41.7%; 81 of 194 patients) when compared with the SI lower than 1 (74.7%; 145 of 194 patients). Importantly, patients classified as low risk in the sPESI had no 30-day mortality compared with 2.1% of patients (3 of 145) classified as low-risk based on the SI. The 3-year mortality rate in low-risk patients according to the sPESI was lower than that in low-risk patients identified based on the SI (4.9% vs. 20.7%; P <0.0001). While a multivariate Cox analysis showed that both the SI and sPESI were independent prognostic variables for 3-year mortality, it showed that only the SI was an independent prognostic variable for 30-day mortality.
  
  
  CONCLUSIONS
  Both prognostic models allow to stratify the risk of short- and long-term mortality in patients with PE, but the sPESI was better than SI at classifying low-risk patients.
authors.forename: Talat
authors.initials: T
authors.lastname: Kilic
authors.forename: Hilal
authors.initials: H
authors.lastname: Ermis
authors.forename: Gazi
authors.initials: G
authors.lastname: Gülbas
authors.forename: Omar
authors.initials: O
authors.lastname: Kaya
authors.forename: Zeynep A
authors.initials: ZA
authors.lastname: Aytemur
authors.forename: Feyza
authors.initials: F
authors.lastname: Inceoglu
authors.forename: Suleyman S
authors.initials: SS
authors.lastname: Hacievliyagil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D012720:Severity of Illness Index; D012769:Shock / Q000175:diagnosis* / Q000401:mortality*
chemical_list: D000925:Anticoagulants