Performance of the Simplified Pulmonary Embolism Severity Index in predicting 30-day mortality after acute pulmonary embolism: Validation from a large-scale cohort

作者全名：Zhang, Yu; Chen, Yinong; Chen, Hong; Dong, Chunling; Hu, Xiaoyun; Xu, Xiaomao; Zhu, Ling; Cheng, Zhe; Wang, Dingyi; Zhang, Zhu; Xie, Wanmu; Wan, Jun; Yang, Peiran; Wang, Shengfeng; Wang, Chen; Zhai, Zhenguo

作者地址：[Zhang, Yu; Wang, Chen; Zhai, Zhenguo] Capital Med Univ, China Japan Friendship Hosp, Beijing, Peoples R China; [Zhang, Yu; Chen, Yinong; Wang, Dingyi; Zhang, Zhu; Xie, Wanmu; Wang, Chen; Zhai, Zhenguo] China Japan Friendship Hosp, Chinese Acad Med Sci, Inst Resp Med, Natl Ctr Resp Med,State Key Lab Resp Hlth & Multim, Beijing, Peoples R China; [Chen, Yinong; Wang, Chen; Zhai, Zhenguo] Peking Univ China, Japan Friendship Sch Clin Med, Beijing, Peoples R China; [Chen, Hong] Chongqing Med Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, Chongqing, Peoples R China; [Dong, Chunling] Second Hosp Jilin Univ, Dept Pulm & Crit Care Med, Changchun, Peoples R China; [Hu, Xiaoyun] First Hosp Shanxi Med Univ, Dept Pulm & Crit Care Med, Taiyuan, Peoples R China; [Xu, Xiaomao] Beijing Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China; [Zhu, Ling] Shandong First Med Univ, Dept Pulm & Crit Care Med, Shandong Prov Hosp, Jinan, Peoples R China; [Cheng, Zhe] Zhengzhou Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, Zhengzhou, Peoples R China; [Wang, Dingyi] China Japan Friendship Hosp, Inst Clin Med Sci, Data & Project Management Unit, Beijing, Peoples R China; [Wan, Jun] Capital Med Univ, Beijing Anzhen Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China; [Yang, Peiran] Chinese Acad Med Sci, Inst Basic Med Sci, State Key Lab Resp Hlth & Multimorbid, Dept Physiol, Beijing, Peoples R China; [Yang, Peiran] Peking Union Med Coll, Sch Basic Med, Beijing, Peoples R China; [Wang, Shengfeng] Peking Univ Hlth Sci Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China

通信作者：Wang, C; Zhai, ZG (通讯作者)，Capital Med Univ, China Japan Friendship Hosp, Beijing, Peoples R China.; Wang, C; Zhai, ZG (通讯作者)，China Japan Friendship Hosp, Chinese Acad Med Sci, Inst Resp Med, Natl Ctr Resp Med,State Key Lab Resp Hlth & Multim, Beijing, Peoples R China.; Wang, C; Zhai, ZG (通讯作者)，Peking Univ China, Japan Friendship Sch Clin Med, Beijing, Peoples R China.

来源：EUROPEAN JOURNAL OF INTERNAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001250990700001

JCR分区：Q1

影响因子：5.9

年份：2024

卷号：124

期号：　

开始页：46

结束页：53

文献类型：Article

关键词：Acute pulmonary embolism; sPESI; Prognostic scores; Mortality

摘要：Background: The performance of existing prognostic scores including the simplified Pulmonary Embolism Severity Index (sPESI) for short-term mortality of non-high-risk PE in Chinese population has not been widely validated. Methods: Non-high-risk patients were included from the prospective cohort of the China pUlmonary Thromboembolism REgistry Study (CURES). The sPESI, RIETE, Geneva, modified FAST, and Bova score were validated. The discriminatory performance was measured by the area under the curve (AUC). We also compared the sensitivity, odds ratio, specificity, positive predictive value and negative predictive value of these scores. Results: A total of 6,873 non-high-risk patients with acute PE were included and 241 (3.5 %) patients died within 30 days. Compared to the Geneva, modified FAST, and Bova score, the AUCs for predicting 30-day death of sPESI and RIETE score were higher at 0.712 (95 % CI, 0.680, 0.743) and 0.723 (95 % CI, 0.691, 0.755) respectively. The sPESI demonstrated the highest sensitivity at 0.809, while the RIETE score, Geneva, Modified FAST and BOVA score showed sensitivities of 0.622, 0.568, 0.477 and 0.502 respectively. A sPESI >= 1 point was associated with a 4.7-fold increased risk of 30-day all-cause mortality (95 % CI, 3.427, 6.563, p < 0.001), while a RIETE score of >= 1 point was associated with a 4.5-fold increased risk (95 % CI, 3.127, 6.341, p < 0.001). The Geneva score, modified FAST and Bova score showed inferior performance. Conclusions: The implementation of the fewer -parameter, easier -to -calculate sPESI in Chinese patients with PE can help to discriminate patients with extremely low risk of short-term mortality for home treatment or early discharge.

基金机构：CAMS Innovation Fund for Medical Sciences (CIFMS) [2021-I2M-1-049, 2021-I2M-1-061]; National High Level Hospital Clinical Research Funding [2022-NHLHCRF-LX-01]; Fund of The National Key Research and Development Program of China [2016YFC0905600]

基金资助正文：This work was supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (grant number 2021-I2M-1-061) , CAMS Innovation Fund for Medical Sciences (CIFMS) (grant number 2021-I2M-1-049) , National High Level Hospital Clinical Research Funding (grant number 2022-NHLHCRF-LX-01) , the Fund of The National Key Research and Development Program of China (grant number 2016YFC0905600) .