Murguia Adrian Rojas, Segovia Fernando, Ayvali Fatih, Brockman Michael, Prakash Swathi, Singh Vishwajeet, Dwivedi Alok Kumar, Rajachandran Manu, Mukherjee Debabrata, Nickel Nils P
Division of Internal Medicine, Texas Tech University Health Sciences Center-El Paso, El Paso, TX, USA.
Biostatistics and Epidemiology Consulting Lab, Office of Research, Texas Tech University Health Sciences Center-El Paso, El Paso, TX, USA.
Angiology. 2025 Aug;76(7):629-636. doi: 10.1177/00033197241230716. Epub 2024 Jan 30.
Risk stratification plays an essential role in the management of acute pulmonary embolism (PE). Several risk scores have been studied to support risk stratification and management. While ethnic differences in acute PE risk factors exist, current risk scores lack validation for Hispanic patients. Therefore, the present study retrospectively investigated the performance of the pulmonary embolism severity index (PESI), simplified PESI (sPESI), the European Society of Cardiology risk assessment (ESC), and the Bova score, to predict 30-day mortality in Hispanic patients presenting with an acute PE. Among 437 patients admitted with acute PE, 30-day mortality was 10.8%; 30-day mortality in low-risk groups ranged from 0% (sPESI, ESC) to 0.2% (PESI, Bova), and 3.0% (Bova) to 5.7% (PESI) in the highest risk groups, respectively. All four scores produced statistically significant discrimination between different risk strata. However, no single scoring system was able to identify all patients with 30-day mortality. The findings of the present study suggest that PESI, sPESI, ESC, and Bova scores provide important information about 30-day mortality in Hispanic in-patients presenting with acute PE. However, additional clinical information could further improve predictability that is not provided by a single scoring system.
风险分层在急性肺栓塞（PE）的管理中起着至关重要的作用。已经对几种风险评分进行了研究，以支持风险分层和管理。虽然急性PE风险因素存在种族差异，但目前的风险评分缺乏对西班牙裔患者的验证。因此，本研究回顾性调查了肺栓塞严重程度指数（PESI）、简化PESI（sPESI）、欧洲心脏病学会风险评估（ESC）和博瓦评分在预测急性PE的西班牙裔患者30天死亡率方面的表现。在437例因急性PE入院的患者中，30天死亡率为10.8%；低风险组的30天死亡率分别为0%（sPESI、ESC）至0.2%（PESI、博瓦），高风险组分别为3.0%（博瓦）至5.7%（PESI）。所有四个评分在不同风险分层之间产生了具有统计学意义的区分。然而，没有单一的评分系统能够识别所有30天内死亡的患者。本研究结果表明，PESI、sPESI、ESC和博瓦评分提供了有关急性PE的西班牙裔住院患者30天死亡率的重要信息。然而，额外的临床信息可以进一步提高单一评分系统无法提供的预测性。
