Ozsu Savas, Ozlu Tevfik, Sentürk Ayşegül, Uçar Elif Yılmazel, Kırkıl Gamze, Kadıoğlu Esra Ekbiç, Altınsoy Bülent, Saylan Bengü, Selimoğlu Hatice Şen, Dabak Gül, Tutar Nuri, Uysal Ahmet
Karadeniz Technical University, School of Medicine, Department of Pulmonary Medicine, Trabzon, Turkey.
Ankara Atatürk Training and Research Hospital, Department of Pulmonary Medicine, Ankara,Turkey.
Thromb Res. 2014 Jun;133(6):1006-10. doi: 10.1016/j.thromres.2014.02.032. Epub 2014 Mar 19.
Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model.
This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding.
Of the 1078 study patients, 95 (8.8%) died within 30days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P=NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%.
The sPESI and the ESC model showed a similar performance regarding 30-day mortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE.
临床参数、生物标志物和基于影像学的风险分层在肺栓塞（PE）中已被广泛接受。本研究调查了简化肺栓塞严重程度指数（sPESI）评分和欧洲心脏病学会（ESC）模型的预后作用。
这项前瞻性队列研究共纳入了来自多中心登记处的1078例患者，这些患者均经客观证实为急性症状性PE。主要终点是前30天内的全因死亡率，次要终点包括全因死亡率、非致命性症状性复发性PE或非致命性大出血。
在1078例研究患者中，95例（8.8%）在诊断后30天内死亡。ESC非低风险患者[12.2%（754例中的103例）]和根据sPESI的高风险患者[11.6%（796例中的103例）]的30天死亡率无显著差异。sPESI低风险组2.8%的患者和ESC低风险组1.9%的患者发生了非致命性次要终点。sPESI低风险组2.2%的患者和ESC低风险组2.2%的患者发生了30天死亡率（P=无统计学意义）。在本研究中，sPESI低风险和ESC模型低风险的组合死亡率为0%。
在本研究中，sPESI和ESC模型在30天死亡率和次要结局方面表现相似。然而，这两种模型的组合在PE中似乎特别有价值。
