Yazıcı Selçuk, Kırış Tuncay, Ceylan Ufuk S, Akyüz Şükrü, Uzun Ahmet O, Hacı Recep, Terzi Sait, Doğan Abdullah, Emre Ayşe, Yeşilçimen Kemal
Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey.
, Cihadiye Street, No: 61/10 A-Blok, 34840, Altıntepe, Maltepe-İstanbul, Turkey.
Wien Klin Wochenschr. 2016 Dec;128(Suppl 8):596-603. doi: 10.1007/s00508-016-1081-y. Epub 2016 Sep 19.
Cardiac troponins and red cell distribution width (RDW) are associated with increased mortality in acute pulmonary embolism (PE). In this study, we aimed to investigate the accuracy of the combined use of troponin and RDW in predicting short-term mortality in acute PE patients.
The data of 201 patients with the diagnosis of acute PE were retrospectively analyzed. We obtained troponin-RDW scores (TR scores) using a combination of troponin and RDW values, and then evaluated this score's accuracy in predicting mortality in patients with acute PE.
The mean participant age was 68 ± 16 years, and 52 % of patients were female. Fifteen (7.4 %) patients died during the first month. Patients classified as high-risk according to TR scores were older (72 ± 15 vs. 66 ± 15 years, p = 0.005), and they had higher heart rates (101 ± 20 vs. 90 ± 15 beat/min, p < 0.001) and respiratory rates (23 ± 4 vs. 21 ± 3 breath/min, p = 0.001). In multivariate analysis, TR (odds ratio [OR] 4.93, 95 % confidence interval [CI] 1.13-21.38, p = 0.033) and simplified pulmonary embolism severity index (sPESI) scores (OR 3.78, 95 % CI 1.71-8.37, p = 0.002) were independent predictors of 30-day mortality. For 30-day mortality, the TR score had a slightly lower sensitivity (87 % vs. 93 %), but a higher specificity (69 % vs. 52 %) compared to the sPESI score.
The TR score is easy to calculate, and it may be used to predict early mortality in patients with acute PE.
心肌肌钙蛋白和红细胞分布宽度（RDW）与急性肺栓塞（PE）患者死亡率升高相关。在本研究中，我们旨在探讨联合使用肌钙蛋白和RDW预测急性PE患者短期死亡率的准确性。
回顾性分析201例诊断为急性PE患者的数据。我们结合肌钙蛋白和RDW值获得肌钙蛋白-RDW评分（TR评分），然后评估该评分预测急性PE患者死亡率的准确性。
参与者的平均年龄为68±16岁，52%为女性。15例（7.4%）患者在第一个月内死亡。根据TR评分分类为高危的患者年龄更大（72±15岁对66±15岁，p=0.005），心率更高（101±20次/分对90±15次/分，p<0.001），呼吸频率更高（23±4次/分对21±3次/分，p=0.001）。多因素分析中，TR（比值比[OR]4.93，95%置信区间[CI]1.13-21.38，p=0.033）和简化肺栓塞严重指数（sPESI）评分（OR 3.78，95%CI 1.71-8.37，p=0.002）是30天死亡率的独立预测因素。对于30天死亡率，与sPESI评分相比，TR评分的敏感性略低（87%对93%），但特异性更高（69%对52%）。
TR评分易于计算，可用于预测急性PE患者的早期死亡率。
