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The Egyptian Journal of Bronchology
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Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism

Egyptian Journal of Bronchology volume 13, pages 747–753 (2019)Cite this article

Abstract

Background

Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is needed for proper management. Several prognostic models have been proposed.

Aim

The aim was to validate the original pulmonary embolism severity index (o-PESI) with its simplified version (s-PESI) and modified version (m-PESI) as predictors of in-hospital mortality and homeostatic morbidities (nonlethal repeated venous thromboembolism, and/or nonlethal serious hemorrhage) in patients with PE.

Patients and methods

Patients proved to have acute PE admitted to Menoufia and Cairo University Hospitals between March 2017 and March 2019 were included in the study. The o-PESI, s-PESI, and m-PESI were calculated for each patient. In-hospital mortality, homeostatic morbidities, and major adverse events (mortality and homeostatic morbidities) were registered.

Results

One hundred and two patients were recruited. Inhospital mortality rate was 13.7%, morbidity rate was 21.6%, whereas major adverse events rate was 31%. The s-PESI classified 31.4% of patients as low risk, and none of them had in-hospital mortality. The frequencies of major adverse events in the low-risk groups were 31.2, 9.1, and 75% for o-PESI, s-PESI, and m-PESI, respectively. Difference between adverse events and non-adverse events groups was significant when s-PESI was applied (P=0.008). The s-PESI had the highest sensitivity and negative predictive value in detecting mortality, morbidity, and major adverse events compared with o-PESI and m-PESI. The area under the curve for s-PESI was significantly above the other two indices (area under the curve=0.78, P=0.04).

Conclusion

In addition to its easy application, the s-PESI has a preferably superior prognostic accuracy than o-PESI and m-PESI in prognostication of low-risk patients with acute PE.

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Authors and Affiliations

  1. Chest Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt

    Maha Yousif MD

  2. Chest Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Sabah A. Hussein

Authors
  1. Maha Yousif MD
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  2. Sabah A. Hussein
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Correspondence to Maha Yousif MD.

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Yousif, M., Hussein, S.A. Original, simplified, and modified pulmonary embolism severity indices in risk stratification of pulmonary embolism. Egypt J Bronchol 13, 747–753 (2019). https://doi.org/10.4103/ejb.ejb_68_19

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