Altınsoy Kazım Ersin
Department of Emergency Medicine, Gaziantep City Hospital, Gaziantep Islam Science and Technology University, Gaziantep, Türkiye.
BMC Emerg Med. 2025 Jun 7;25(1):96. doi: 10.1186/s12873-025-01259-z.
Pulmonary embolism (PE) is a life-threatening condition requiring rapid risk stratification for optimal management. The Pulmonary Embolism Advanced Cardiac Evaluation (PEACE) Score is a novel tool integrating clinical, laboratory, and echocardiographic parameters to assess disease severity. This study aimed to evaluate the correlation between PEACE Score and echocardiographic abnormalities in PE patients, and to determine its effectiveness as a rapid risk assessment tool in emergency settings.
Between June 2020 and June 2024, 120 patients were prospectively screened and enrolled in the study after being diagnosed with pulmonary embolism via CT angiography in the emergency department. Patients were categorized into three groups according to PEACE score as low risk (< 3 points, n = 42), intermediate risk (3-5 points, n = 52) and high risk (> 5 points, n = 26). Echocardiographic findings were not used for stratification but rather analyzed as outcome variables to assess the discriminative validity of the PEACE Score. Demographic data, laboratory findings and echocardiographic parameters were recorded. Patients were followed up for at least 1 year. Follow-up from 3 months to 6 months was evaluated and mortality rates at the end of 1 year were determined.
PEACE Score was strongly correlated with echocardiographic abnormalities (r = 0.685, p < 0.001) and inflammatory markers, including CRP (r = 0.524, p < 0.001). The PEACE Score had the highest diagnostic value for predicting echocardiographic abnormalities, with an AUC of 0.82 (95% CI: 0.74-0.90, p < 0.001). Specifically, in predicting right ventricular dysfunction, the PEACE Score achieved an AUC of 0.85 (95% CI: 0.77-0.93, p < 0.001). A cutoff of > 5 points showed a sensitivity of 84.6% and specificity of 79.2% for detecting severe echocardiographic abnormalities. One-year survival rates were 45% in the high-risk group, 65% in the intermediate-risk group, and 85% in the low-risk group. Kaplan-Meier analysis confirmed significant differences in survival among risk groups (p < 0.001).
The PEACE Score demonstrated a strong association with echocardiographic abnormalities and patient survival in emergency department PE cases. These findings suggest that PEACE may serve as a valuable tool for rapid risk stratification, aiding emergency physicians in early clinical decision-making. Specifically, high PEACE Scores were associated with a greater need for thrombolytic therapy and ICU admission, suggesting its potential utility in guiding treatment escalation and resource allocation in critically ill PE patients.
Not applicable.
肺栓塞（PE）是一种危及生命的疾病，需要进行快速风险分层以实现最佳管理。肺栓塞高级心脏评估（PEACE）评分是一种整合临床、实验室和超声心动图参数以评估疾病严重程度的新型工具。本研究旨在评估PE患者中PEACE评分与超声心动图异常之间的相关性，并确定其作为急诊环境中快速风险评估工具的有效性。
在2020年6月至2024年6月期间，前瞻性筛选了120例患者，这些患者在急诊科经CT血管造影诊断为肺栓塞后纳入研究。根据PEACE评分将患者分为三组：低风险（<3分，n = 42）、中风险（3 - 5分，n = 52）和高风险（>5分，n = 26）。超声心动图结果未用于分层，而是作为结果变量进行分析，以评估PEACE评分的鉴别效度。记录人口统计学数据、实验室检查结果和超声心动图参数。对患者进行至少1年的随访。评估3个月至6个月的随访情况，并确定1年末的死亡率。
PEACE评分与超声心动图异常（r = 0.685，p < 0.001）以及包括CRP在内的炎症标志物（r = 0.524，p < 0.001）密切相关。PEACE评分对预测超声心动图异常具有最高的诊断价值，AUC为0.82（95%CI：0.74 - 0.90，p < 0.001）。具体而言，在预测右心室功能障碍方面，PEACE评分的AUC为0.85（95%CI：0.77 - 0.93，p < 0.001）。>5分的截断值对检测严重超声心动图异常的敏感性为84.6%，特异性为79.2%。高风险组的1年生存率为45%，中风险组为65%，低风险组为85%。Kaplan - Meier分析证实风险组之间的生存存在显著差异（p < 0.001）。
在急诊科的PE病例中，PEACE评分与超声心动图异常及患者生存密切相关。这些发现表明，PEACE可能是一种有价值的快速风险分层工具，有助于急诊医生进行早期临床决策。具体而言，高PEACE评分与溶栓治疗和入住ICU的需求增加相关，表明其在指导危重症PE患者的治疗升级和资源分配方面具有潜在效用。
不适用。
