title: Classification of high-risk with cardiac troponin and shock index in normotensive patients with pulmonary embolism.
abstract: Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission. The primary end-point occurred in 67 (13.7%, 95% CI 10.7-16.8) patients with acute PE. Predictors of complications included elevated cardiac troponin (OR 1.7, 95% CI 1.3-2.2) and shock index (OR 1.3, 95% CI 1.1-1.5) by multivariable analysis. Risk index point was created based on OR. The model identified stages (stage I: 0-1 point, stage II: 2 points and stage III: 3 point) with 30-day mortality rates of 4.3, 19 and 38.6 %, respectively. The shock index and cardiac troponin can be safely used in combination to determine intermediate risk in patients with PE in emergency departmant. The study provided observations that will require prospective validation before the proposed risk score is adopted in clinical practice.
authors: Department of Pulmonary Medicine, School of Medicine, Karadeniz Technical University, Trabzon, Turkey. savasozsu@gmail.com.
authors: Savas
authors: S
authors: Ozsu
authors: Department of Pulmonary Medicine, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors: Muge
authors: M
authors: Erbay
authors: Department of Pulmonary Medicine, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors: Zerrin Gürel
authors: ZG
authors: Durmuş
authors: Department of Pulmonary Medicine, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors: Tevfik
authors: T
authors: Ozlu
mesh_terms: D000368:Aged; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D012720:Severity of Illness Index; D012769:Shock / Q000175:diagnosis*; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I
keywords: Intermediate risk; Pulmonary embolism; Shock index; Troponin