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Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report

Received: 5 June 2015     Accepted: 24 June 2015     Published: 25 June 2015
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Abstract

Background and aim: Prognostic stratification of acute pulmonary embolism (PE) represents the cornerstone of modern management of this potentially life-threatening disease. In the latest years, a lot of clinical prognostic models have been validated. However, these are yet underused in clinical practice, especially in real world populations. The aim of our study was to test the prognostic ability of the Simplified Pulmonary Embolism Severity Index (sPESI) score in a real world population. Methods: Data records of 452 patients that were discharged for acute PE from 28 Internal Medicine wards of Tuscany (Italy) were retrospectively analysed. sPESI was calculated in the identical manner as the original study. Prognostic ability of sPESI score for predicting in-hospital all-cause and PE-related mortality was tested by using Areas under Receiver Operating Characteristics (ROC) curve (AUC). Results: 15.2% of patients were classified as sPESI score 0, whereas 84.8% were classified as sPESI ≥ 1. All causes of in-hospital mortality were 10.95% (5.75% PE-related) in patients with sPESI score ≥ 1 and 0% (0% PE-related) in sPESI score 0. AUC for all causes of mortality was 0.694 (95% CI: 0.650-0.736), whereas it was 0.702 (95% CI: 0.657-0.743) for PE-related mortality. Conclusion: In a real world population, sPESI is a good prognosticator for all causes of in-hospital and PE-related mortality and its use should be encouraged.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 1, Issue 2)
DOI 10.11648/j.ijcems.20150102.14
Page(s) 22-26
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Pulmonary Embolism, Prognosis, PESI Score

References
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[2] Masotti L, Righini M, Vuilleumier N, Antonelli F, Landini G, Cappelli R, Ray P. Prognostic stratification of acute pulmonary embolism: focus on clinical aspects, imaging, and biomarkers. Vasc Health Risk Manag 2009; 5: 567-75.
[3] Becattini C, Agnelli G. Acute pulmonary embolism: risk stratification in the emergency department. Intern Emerg Med 2007; 2: 119-29
[4] Jiménez D, Aujesky D, Moores L et al.; RIETE Investigators. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010; 170: 1383-9.
[5] Lankeit M, Konstantinides S. Is it time for home treatment of pulmonary embolism? Eur Respir J 2012; 40(3): 742-9.
[6] Squizzato A, Galli M, Dentali F, Ageno W. Outpatient treatment and early discharge of symptomatic pulmonary embolism: a systematic review. Eur Respir J 2009; 33: 1148-55.
[7] Aujesky D, Roy PM, Verschuren F, Righini M, Osterwalder J, Egloff M, Renaud B,Verhamme P, Stone RA, Legall C, Sanchez O, Pugh NA, N'gako A, Cornuz J, Hugli O, Beer HJ, Perrier A, Fine MJ, Yealy DM. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomized, non-inferiority trial. Lancet 2011; 2; 378(9785): 41-8.
[8] Authors/Task Force Members, Konstantinides S, Torbicki A, Agnelli G etv al.; Authors/Task Force Members. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS). Eur Heart J 2014; 35: 3033-69.
[9] Masotti L, Mannucci A, Antonelli F, Maurini V, Testa R, Marchetti S, Landini G, Cappelli R. The Risk-based Treatment of Acute Pulmonary Embolism. J Clin Med Res 2009; 1: 1-7.
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[11] Piran S, Le Gal G, Wells PS, Gandara E, Righini M, Rodger MA, Carrier M. Outpatient treatment of symptomatic pulmonary embolism: a systematic review and meta-analysis. Thromb Res 2013; 132: 515-9.
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    Luca Masotti, Grazia Panigada, Giancarlo Landini, Filippo Pieralli, Francesco Corradi, et al. (2015). Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report. International Journal of Clinical and Experimental Medical Sciences, 1(2), 22-26. https://doi.org/10.11648/j.ijcems.20150102.14

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    ACS Style

    Luca Masotti; Grazia Panigada; Giancarlo Landini; Filippo Pieralli; Francesco Corradi, et al. Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report. Int. J. Clin. Exp. Med. Sci. 2015, 1(2), 22-26. doi: 10.11648/j.ijcems.20150102.14

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    AMA Style

    Luca Masotti, Grazia Panigada, Giancarlo Landini, Filippo Pieralli, Francesco Corradi, et al. Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report. Int J Clin Exp Med Sci. 2015;1(2):22-26. doi: 10.11648/j.ijcems.20150102.14

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  • @article{10.11648/j.ijcems.20150102.14,
      author = {Luca Masotti and Grazia Panigada and Giancarlo Landini and Filippo Pieralli and Francesco Corradi and Salvatore Lenti and Rino Migliacci and Carlo Nozzoli and Maddalena Grazzini and Lucia Ciucciarelli and Alessandro Morettini and Sara Bucherelli and Alessandra Petrioli and Carlotta Casati and Mario Felici and Luciano Ralli and Stefano Arrigucci and Laila Teghini and Giovanni Antonio Porciello and Stefano Spolveri and Daniele Baldoni and Anna Frullini and Barbara Cimolato and Gianni Lorenzini and Alessandro Pampana and Guidantonio Rinaldi and Maria Chiara Bertieri and Raffaele Laureano and Stefano Tatini and Alberto Fortini and Chiara Angotti and Valerio Verdiani and Anna Maria Romagnoli and Irene Cascinelli and Alberto Camaiti and Nicola Mumoli and Marco Cei and Stefano Giuntoli and Massimo Alessandri and Alessandro De Palma and Maurizio Manini and Veronica De Crescenzo and Michele Piacentini and Carlo Passaglia and Giancarlo Tintori and Carlo Palermo and Alba Dainelli and Roberto Andreini and Giuseppa Levantino and Plinio Fabiani and Lucia Raimondi and Massimo Di Natale and Filippo Risaliti and Rossella Nassi and Roberta Mastriforti and Roberto Cappelli and Michele Voglino and Paola Lambelet and Stefano Fascietti and Adriano Cioppi and Valentina Carli and Alessandro Tafi and Simone Meini and Emilio Santoro and Claudia Rosi},
      title = {Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {1},
      number = {2},
      pages = {22-26},
      doi = {10.11648/j.ijcems.20150102.14},
      url = {https://doi.org/10.11648/j.ijcems.20150102.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20150102.14},
      abstract = {Background and aim: Prognostic stratification of acute pulmonary embolism (PE) represents the cornerstone of modern management of this potentially life-threatening disease. In the latest years, a lot of clinical prognostic models have been validated. However, these are yet underused in clinical practice, especially in real world populations. The aim of our study was to test the prognostic ability of the Simplified Pulmonary Embolism Severity Index (sPESI) score in a real world population. Methods: Data records of 452 patients that were discharged for acute PE from 28 Internal Medicine wards of Tuscany (Italy) were retrospectively analysed. sPESI was calculated in the identical manner as the original study. Prognostic ability of sPESI score for predicting in-hospital all-cause and PE-related mortality was tested by using Areas under Receiver Operating Characteristics (ROC) curve (AUC). Results: 15.2% of patients were classified as sPESI score 0, whereas 84.8% were classified as sPESI ≥ 1. All causes of in-hospital mortality were 10.95% (5.75% PE-related) in patients with sPESI score ≥ 1 and 0% (0% PE-related) in sPESI score 0. AUC for all causes of mortality was 0.694 (95% CI: 0.650-0.736), whereas it was 0.702 (95% CI: 0.657-0.743) for PE-related mortality. Conclusion: In a real world population, sPESI is a good prognosticator for all causes of in-hospital and PE-related mortality and its use should be encouraged.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Prognostic Ability of Simplified Pulmonary Embolism Severity Index (PESI) Score in Real World: A Brief Report
    AU  - Luca Masotti
    AU  - Grazia Panigada
    AU  - Giancarlo Landini
    AU  - Filippo Pieralli
    AU  - Francesco Corradi
    AU  - Salvatore Lenti
    AU  - Rino Migliacci
    AU  - Carlo Nozzoli
    AU  - Maddalena Grazzini
    AU  - Lucia Ciucciarelli
    AU  - Alessandro Morettini
    AU  - Sara Bucherelli
    AU  - Alessandra Petrioli
    AU  - Carlotta Casati
    AU  - Mario Felici
    AU  - Luciano Ralli
    AU  - Stefano Arrigucci
    AU  - Laila Teghini
    AU  - Giovanni Antonio Porciello
    AU  - Stefano Spolveri
    AU  - Daniele Baldoni
    AU  - Anna Frullini
    AU  - Barbara Cimolato
    AU  - Gianni Lorenzini
    AU  - Alessandro Pampana
    AU  - Guidantonio Rinaldi
    AU  - Maria Chiara Bertieri
    AU  - Raffaele Laureano
    AU  - Stefano Tatini
    AU  - Alberto Fortini
    AU  - Chiara Angotti
    AU  - Valerio Verdiani
    AU  - Anna Maria Romagnoli
    AU  - Irene Cascinelli
    AU  - Alberto Camaiti
    AU  - Nicola Mumoli
    AU  - Marco Cei
    AU  - Stefano Giuntoli
    AU  - Massimo Alessandri
    AU  - Alessandro De Palma
    AU  - Maurizio Manini
    AU  - Veronica De Crescenzo
    AU  - Michele Piacentini
    AU  - Carlo Passaglia
    AU  - Giancarlo Tintori
    AU  - Carlo Palermo
    AU  - Alba Dainelli
    AU  - Roberto Andreini
    AU  - Giuseppa Levantino
    AU  - Plinio Fabiani
    AU  - Lucia Raimondi
    AU  - Massimo Di Natale
    AU  - Filippo Risaliti
    AU  - Rossella Nassi
    AU  - Roberta Mastriforti
    AU  - Roberto Cappelli
    AU  - Michele Voglino
    AU  - Paola Lambelet
    AU  - Stefano Fascietti
    AU  - Adriano Cioppi
    AU  - Valentina Carli
    AU  - Alessandro Tafi
    AU  - Simone Meini
    AU  - Emilio Santoro
    AU  - Claudia Rosi
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    DO  - 10.11648/j.ijcems.20150102.14
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 22
    EP  - 26
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20150102.14
    AB  - Background and aim: Prognostic stratification of acute pulmonary embolism (PE) represents the cornerstone of modern management of this potentially life-threatening disease. In the latest years, a lot of clinical prognostic models have been validated. However, these are yet underused in clinical practice, especially in real world populations. The aim of our study was to test the prognostic ability of the Simplified Pulmonary Embolism Severity Index (sPESI) score in a real world population. Methods: Data records of 452 patients that were discharged for acute PE from 28 Internal Medicine wards of Tuscany (Italy) were retrospectively analysed. sPESI was calculated in the identical manner as the original study. Prognostic ability of sPESI score for predicting in-hospital all-cause and PE-related mortality was tested by using Areas under Receiver Operating Characteristics (ROC) curve (AUC). Results: 15.2% of patients were classified as sPESI score 0, whereas 84.8% were classified as sPESI ≥ 1. All causes of in-hospital mortality were 10.95% (5.75% PE-related) in patients with sPESI score ≥ 1 and 0% (0% PE-related) in sPESI score 0. AUC for all causes of mortality was 0.694 (95% CI: 0.650-0.736), whereas it was 0.702 (95% CI: 0.657-0.743) for PE-related mortality. Conclusion: In a real world population, sPESI is a good prognosticator for all causes of in-hospital and PE-related mortality and its use should be encouraged.
    VL  - 1
    IS  - 2
    ER  - 

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Author Information
  • Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy

  • Internal Medicine, Pescia Hospital, Pistoia, Italy

  • Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Arezzo Hospital, Arezzo, Italy

  • Internal Medicine, Cortona Hospital, Arezzo, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Careggi Hospital, Florence, Italy

  • Internal Medicine, Arezzo Hospital, Arezzo, Italy

  • Internal Medicine, Arezzo Hospital, Arezzo, Italy

  • Internal Medicine, Arezzo Hospital, Arezzo, Italy

  • Internal Medicine, Pescia Hospital, Pistoia, Italy

  • Internal Medicine, Cortona Hospital, Arezzo, Italy

  • Internal Medicine, Borgo San Lorenzo Hospital, Florence, Italy

  • Internal Medicine, Borgo San Lorenzo Hospital, Florence, Italy

  • Internal Medicine, Borgo San Lorenzo Hospital, Florence, Italy

  • Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy

  • Internal Medicine, Cecina Hospital, Livorno, Italy

  • Internal Medicine, Cecina Hospital, Livorno, Italy

  • Internal Medicine, Barga Hospital, Lucca, Italy

  • Internal Medicine, Barga Hospital, Lucca, Italy

  • Internal Medicine, Santa Maria Annunziata Hospital, Florence, Italy

  • Internal Medicine, Santa Maria Annunziata Hospital, Florence, Italy

  • Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy

  • Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy

  • Internal Medicine, Grosseto Hospital, Grosseto, Italy

  • Internal Medicine, Grosseto Hospital, Grosseto, Italy

  • Internal Medicine, Grosseto Hospital, Grosseto, Italy

  • Internal Medicine, Livorno Hospital, Livorno, Italy

  • Internal Medicine, Livorno Hospital, Livorno, Italy

  • Internal Medicine, Livorno Hospital, Livorno, Italy

  • Internal Medicine, Livorno Hospital, Livorno, Italy

  • Internal Medicine, Massa Marittima Hospital, Grosseto, Italy

  • Internal Medicine, Massa Marittima Hospital, Grosseto, Italy

  • Internal Medicine, Orbetello Hospital, Grosseto, Italy

  • Internal Medicine, Orbetello Hospital, Grosseto, Italy

  • Internal Medicine, Piombino Hospital, Livorno, Italy

  • Internal Medicine, Cisanello Hospital, Pisa, Italy

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  • Internal Medicine, Campostaggia Hospital, Siena, Italy

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  • Internal Medicine, Pontedera Hospital, Florence, Italy

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  • Internal Medicine, Portoferraio Hospital, Livorno, Italy

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