Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

In young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged <50...

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Autores: Jara-Palomares L, Alfonso M, Maestre A, Jimenez D, Garcia-Bragado F, Font C, Reyes RL, Blasco LH, Vidal G, Otero R, Monreal M, RIETE investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p7261
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/7261
Access Level:acceso abierto
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spelling Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 yearsJara-Palomares LAlfonso MMaestre AJimenez DGarcia-Bragado FFont CReyes RLBlasco LHVidal GOtero RMonreal MRIETE investigatorsIn young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged <50 years. We used the RIETE database, including PE patients from 2001 to 2017. The major outcome was 30-day all-cause mortality. Of 34,651 patients with acute PE, 5,822 (17%) were aged <50 years. Of these, 83 (1.4%) died during the first 30 days. Number of patients deemed low risk with tools was: PREP (95.9%), GPS (89.6%), PESI (87.2%), Shock index (70.9%), sPESI (59.4%), Prognostic algorithm (58%) and RIETE score (48.6%). The tools with a highest sensitivity were: Prognostic Algorithm (91.6%; 95% CI: 85.6-97.5), RIETE score (90.4%; 95%CI: 84.0-96.7) and sPESI (88%; 95% CI: 81-95). The RIETE, Prognostic Algorithm and sPESI scores obtained the highest overall sensitivity estimates for also predicting 7- and 90-day all-cause mortality, 30-day PE-related mortality, 30-day major bleeding and 30-day VTE recurrences. The proportion of low-risk patients who died within the first 30 days was lowest using the Prognostic Algorithm (0.2%), RIETE (0.3%) or sPESI (0.3%) scores. In PE patients less 50 years, 30-day mortality was low. Although sPESI, RIETE and Prognostic Algorithm scores were the most sensitive tools to identify patients at low risk to die, other tools should be evaluated in this population to obtain more efficient results.NATURE PORTFOLIO2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/7261Scientific ReportsISSN: 20452322reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p72612026-06-11T12:45:17Z
dc.title.none.fl_str_mv Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
title Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
spellingShingle Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
Jara-Palomares L
title_short Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
title_full Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
title_fullStr Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
title_full_unstemmed Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
title_sort Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years
dc.creator.none.fl_str_mv Jara-Palomares L
Alfonso M
Maestre A
Jimenez D
Garcia-Bragado F
Font C
Reyes RL
Blasco LH
Vidal G
Otero R
Monreal M
RIETE investigators
author Jara-Palomares L
author_facet Jara-Palomares L
Alfonso M
Maestre A
Jimenez D
Garcia-Bragado F
Font C
Reyes RL
Blasco LH
Vidal G
Otero R
Monreal M
RIETE investigators
author_role author
author2 Alfonso M
Maestre A
Jimenez D
Garcia-Bragado F
Font C
Reyes RL
Blasco LH
Vidal G
Otero R
Monreal M
RIETE investigators
author2_role author
author
author
author
author
author
author
author
author
author
author
description In young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged <50 years. We used the RIETE database, including PE patients from 2001 to 2017. The major outcome was 30-day all-cause mortality. Of 34,651 patients with acute PE, 5,822 (17%) were aged <50 years. Of these, 83 (1.4%) died during the first 30 days. Number of patients deemed low risk with tools was: PREP (95.9%), GPS (89.6%), PESI (87.2%), Shock index (70.9%), sPESI (59.4%), Prognostic algorithm (58%) and RIETE score (48.6%). The tools with a highest sensitivity were: Prognostic Algorithm (91.6%; 95% CI: 85.6-97.5), RIETE score (90.4%; 95%CI: 84.0-96.7) and sPESI (88%; 95% CI: 81-95). The RIETE, Prognostic Algorithm and sPESI scores obtained the highest overall sensitivity estimates for also predicting 7- and 90-day all-cause mortality, 30-day PE-related mortality, 30-day major bleeding and 30-day VTE recurrences. The proportion of low-risk patients who died within the first 30 days was lowest using the Prognostic Algorithm (0.2%), RIETE (0.3%) or sPESI (0.3%) scores. In PE patients less 50 years, 30-day mortality was low. Although sPESI, RIETE and Prognostic Algorithm scores were the most sensitive tools to identify patients at low risk to die, other tools should be evaluated in this population to obtain more efficient results.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/7261
url https://fisabio.portalinvestigacion.com/publicaciones/7261
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv NATURE PORTFOLIO
publisher.none.fl_str_mv NATURE PORTFOLIO
dc.source.none.fl_str_mv Scientific Reports
ISSN: 20452322
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
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