Korkut Mustafa, Yavuz Alpaslan, Selvi Fatih, Zortuk Ökkeş, İnan Erdinç Hakan, Güven Hasan Can
Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.
Department of Radiology, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.
Acta Radiol. 2024 Dec;65(12):1482-1490. doi: 10.1177/02841851241289693. Epub 2024 Oct 24.
Acute pulmonary embolism (PE) is a disease with a serious prognosis and a high probability of death in the emergency department.
To investigate the prediction of PE-related mortality and intensive care admission (ICU) of Qanadli (Qscore), Bova, and simplified Pulmonary Embolism Severity Index (sPESI) scores.
This retrospective observational study consisted of all patients diagnosed with acute PE who were imaged under computed tomography pulmonary angiography (CTPA) for a total of 5 years between 1 June 2018 and 1 June 2023. The prediction of radiological and clinical scores for mortality and ICU admission was examined.
A total of 95 patients were analyzed. Patients who died and those who were admitted to the ICU had a significantly higher frequency of being found to have a high-risk (≥1) sPESI score ( = 0.04 and = 0.016, respectively). For mortality, the sPESI score was found to be significant; the sensitivity and specificity were observed as 54% and 66% (area under the curve [AUC]=0.670, 95% confidence interval [CI]=0.527-0.814; = 0.020). For ICU admission, the sensitivity and specificity of the Qscore, sPESI, and Bova scores were 35%, 77%, and 58%, and 78%, 65%, and 84% respectively (AUC=0.626, 95% CI=0.511-0.740, = 0.031; AUC=0.769, 95% CI=0.674-0.865, < 0.001; and AUC=0.767, 95% CI=0.671-0.862, < 0.001, respectively).
It was found that the sPESI score was effective at predicting mortality in patients with acute PE. Qscore, sPESI, and Bova scores have been shown to be useful in predicting ICU admission.
急性肺栓塞（PE）是一种预后严重且在急诊科死亡概率较高的疾病。
研究卡纳德利（Qscore）、博瓦（Bova）和简化肺栓塞严重程度指数（sPESI）评分对PE相关死亡率和重症监护病房（ICU）收治情况的预测价值。
这项回顾性观察性研究纳入了2018年6月1日至2023年6月1日期间所有经计算机断层扫描肺动脉造影（CTPA）成像诊断为急性PE的患者，为期5年。研究了死亡率和ICU收治情况的影像学和临床评分预测。
共分析了95例患者。死亡患者和入住ICU的患者中，高危（≥1）sPESI评分的检出频率显著更高（分别为=0.04和=0.016）。对于死亡率，sPESI评分具有显著性；观察到的敏感性和特异性分别为54%和66%（曲线下面积[AUC]=0.670，95%置信区间[CI]=0.527 - 0.814；=0.020）。对于ICU收治情况，Qscore、sPESI和Bova评分的敏感性和特异性分别为35%、77%和58%，以及78%、65%和84%（AUC=0.626，95% CI=0.511 - 0.740，=0.031；AUC=0.769，95% CI=0.674 - 0.865，<0.001；AUC=0.767，95% CI=0.671 - 0.862，<0.001）。
发现sPESI评分在预测急性PE患者的死亡率方面有效。Qscore、sPESI和Bova评分已被证明在预测ICU收治情况方面有用。
