Validation of a clinical algorithm to identify low-risk patients with pulmonary embolism.

Details

Serval ID
serval:BIB_85A324FBC1D6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Validation of a clinical algorithm to identify low-risk patients with pulmonary embolism.
Journal
Journal of Thrombosis and Haemostasis
Author(s)
Jakobsson C., Jiménez D., Gómez V., Zamarro C., Méan M., Aujesky D.
ISSN
1538-7836[electronic], 1538-7836[linking]
Publication state
Published
Issued date
2010
Volume
8
Number
6
Pages
1242-1247
Language
english
Abstract
Summary Background:
We previously derived a clinical prognostic algorithm to identify patients with pulmonary embolism (PE) who are at low-risk of short-term mortality who could be safely discharged early or treated entirely in an outpatient setting.
Objectives:
To externally validate the clinical prognostic algorithm in an independent patient sample.
Methods:
We validated the algorithm in 983 consecutive patients prospectively diagnosed with PE at an emergency department of a university hospital. Patients with none of the algorithm's 10 prognostic variables (age >/= 70 years, cancer, heart failure, chronic lung disease, chronic renal disease, cerebrovascular disease, pulse >/= 110/min., systolic blood pressure < 100 mm Hg, oxygen saturation < 90%, and altered mental status) at baseline were defined as low-risk. We compared 30-day overall mortality among low-risk patients based on the algorithm between the validation and the original derivation sample. We also assessed the rate of PE-related and bleeding-related mortality among low-risk patients.
Results:
Overall, the algorithm classified 16.3% of patients with PE as low-risk. Mortality at 30 days was 1.9% among low-risk patients and did not differ between the validation and the original derivation sample. Among low-risk patients, only 0.6% died from definite or possible PE, and 0% died from bleeding.
Conclusions:
This study validates an easy-to-use, clinical prognostic algorithm for PE that accurately identifies patients with PE who are at low-risk of short-term mortality. Low-risk patients based on our algorithm are potential candidates for less costly outpatient treatment.
Keywords
Mortality, Prognosis, Pulmonary Embolism, Molecular-Weight Heparin, Deep-Vein Thrombosis, Unfractionated Heparin, Outpatient Treatment, Prognostic Value, Metaanalysis, Prediction, Management, Cohort
Pubmed
Web of science
Open Access
Yes
Create date
30/06/2010 10:49
Last modification date
16/10/2019 10:52
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