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非大面积肺栓塞中 Qanadli 评分与传统危险分层因子的比较。

Comparison of Qanadli score with conventional risk stratifiers in non-massive pulmonary emboli.

机构信息

Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.

Department of Cardiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Int Med Res. 2024 Sep;52(9):3000605241276481. doi: 10.1177/03000605241276481.

Abstract

OBJECTIVE

The management and risk stratification of non-massive pulmonary embolism (PE) remain unclear. However, early assessment of PE severity can aid physicians in establishing better treatment milestones. There has been no direct comparison of mortality rates in patients with non-massive PE, and existing data are sometimes contradictory. Therefore, we examined the relationship between the Qanadli index and conventional risk stratifiers in PE.

METHODS

We retrospectively analyzed 200 consecutively selected patients diagnosed with PE. The assessment included computed tomography pulmonary angiography, electrocardiography, echocardiography findings, outcomes, and a comparison with the Simplified Pulmonary Embolism Severity Index (SPESI) score. Descriptive, regression, and receiver operating characteristic analyses were performed.

RESULTS

The mean Qanadli score was 13.5 ± 1.15. Pearson correlation analysis revealed significant associations between the total Qanadli score and several variables: right ventricular enlargement, follow-up ejection fraction, and SPESI score. Although the Qanadli score did not significantly predict mortality, the risk of death increased by 58.8% for each 1-unit increase in the SPESI score.

CONCLUSIONS

Although the Qanadli index is valuable in assessing PE and guiding treatment strategies, its standalone predictive value for mortality may be insufficient. Therefore, incorporating scoring systems such as the SPESI and echocardiographic findings is recommended for more accurate mortality prediction.

摘要

目的

非大面积肺栓塞(PE)的管理和风险分层仍不明确。然而,早期评估 PE 的严重程度可以帮助医生制定更好的治疗里程碑。目前尚无非大面积 PE 患者死亡率的直接比较,而且现有数据有时相互矛盾。因此,我们研究了 Qanadli 指数与 PE 中常规风险分层因素之间的关系。

方法

我们回顾性分析了 200 例连续选择的 PE 患者。评估包括计算机断层扫描肺动脉造影、心电图、超声心动图结果以及与简化肺栓塞严重程度指数(SPESI)评分的比较。进行了描述性、回归和接收者操作特征分析。

结果

平均 Qanadli 评分为 13.5±1.15。Pearson 相关分析显示,总 Qanadli 评分与多个变量之间存在显著关联:右心室扩大、随访射血分数和 SPESI 评分。虽然 Qanadli 评分不能显著预测死亡率,但 SPESI 评分每增加 1 个单位,死亡风险增加 58.8%。

结论

尽管 Qanadli 指数在评估 PE 和指导治疗策略方面具有价值,但单独使用该指数预测死亡率的价值可能不足。因此,建议结合 SPESI 和超声心动图等评分系统进行更准确的死亡率预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f5/11418528/73de2d3b54a2/10.1177_03000605241276481-fig1.jpg

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