Identification of Low-Risk Patients with Acute Symptomatic Pulmonary Embolism for Outpatient Therapy.
Details
Serval ID
serval:BIB_518589DC9FC9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Identification of Low-Risk Patients with Acute Symptomatic Pulmonary Embolism for Outpatient Therapy.
Journal
Annals of the American Thoracic Society
Working group(s)
RIETE Investigators
Contributor(s)
Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Bertoletti L., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R., Wells P., Papadakis M., Monreal M., Adarraga MD., Andújar V., Arcelus JI., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Benítez JF., Blanco-Molina A., Bueso T., Cañas I., Casado I., Chaves EL., del Molino F., del Toro J., Díaz JA., Falgá C., Fernández-Capitán C., Font L., Gallego P., García-Bragado F., García-Ortega A., García-Rodríguez A., Gómez V., González J., Grau E., Guijarro R., Guil M., Gutiérrez-Guisado J., Hernández-Blasco L., Jara-Palomares L., Jaras MJ., Jiménez D., Jiménez R., Lacruz B., Lecumberri R., Lobo JL., López-Jiménez L., López-Montes L., López-Reyes R., López-Sáez JB., Lorente MA., Lorenzo A., Madridano O., Maestre A., Marchena PJ., Martín-Antorán JM., Martín-Martos F., Monreal M., Morales MV., Nauffal D., Nieto JA., Núñez MJ., Otero R., Pagán B., Pedrajas JM., Peris ML., Ponce de León L., Pons I., Porras JA., Riera-Mestre A., Rivas A., Rodríguez-Dávila MA., Rosa V., Ruiz-Giménez N., Sabio P., Sampériz A., Sánchez R., Sanz O., Soler S., Soto MJ., Suriñach JM., Tiberio G., Tirado R., Tolosa C., Trujillo-Santos J., Uresandi F., Valero B., Valle R., Vela J., Vidal G., Vilar C., Villalobos A., Villalta J., Malfante P., Vanassche T., Verhamme P., Wells P., Hirmerova J., Malý R., Miklo?ová M. , Bertoletti L., Bura-Riviere A., Farge-Bancel D., Hij A., Mahe I., Merah A., Moustafa F., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Apollonio A., Barillari G., Bucherini E., Campodomico J., Ciammaichella M., De Ciantis P., Di Micco P., Ferrazzi P., Maida R., Mastroiacovo D., Pace F., Pasca S., Pesavento R., Pinelli M., Piovella C., Prandoni P., Rota L., Tiraferri E., Tonello D., Tufano A., Visonà A., Zalunardo B., Belovs A., Skride A., Ferreira R., Ribeiro JL., Sousa MS., Bosevski M., Alatri A., Bounameaux H., Mazzolai L., Serrano JC.
ISSN
2325-6621 (Electronic)
ISSN-L
2325-6621
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
12
Number
8
Pages
1122-1129
Language
english
Notes
Alatri A. is a RIETE investigator
Abstract
RATIONALE: Patients with acute symptomatic pulmonary embolism (PE) deemed to be at low risk for early complications might be candidates for partial or complete outpatient treatment.
OBJECTIVES: To develop and validate a clinical prediction rule that accurately identifies patients with PE and low risk of short-term complications and to compare its prognostic ability with two previously validated models (i.e., the Pulmonary Embolism Severity Index [PESI] and the Simplified PESI [sPESI])
METHODS: Multivariable logistic regression of a large international cohort of patients with PE prospectively enrolled in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry.
MEASUREMENTS AND MAIN RESULTS: All-cause mortality, recurrent PE, and major bleeding up to 10 days after PE diagnosis were determined. Of 18,707 eligible patients with acute symptomatic PE, 46 (0.25%) developed recurrent PE, 203 (1.09%) bled, and 471 (2.51%) died. Predictors included in the final model were chronic heart failure, recent immobilization, recent major bleeding, cancer, hypotension, tachycardia, hypoxemia, renal insufficiency, and abnormal platelet count. The area under receiver-operating characteristic curve was 0.77 (95% confidence interval [CI], 0.75-0.78) for the RIETE score, 0.72 (95% CI, 0.70-0.73) for PESI (P < 0.05), and 0.71 (95% CI, 0.69-0.73) for sPESI (P < 0.05). Our RIETE score outperformed the prognostic value of PESI in terms of net reclassification improvement (P < 0.001), integrated discrimination improvement (P < 0.001), and sPESI (net reclassification improvement, P < 0.001; integrated discrimination improvement, P < 0.001).
CONCLUSIONS: We built a new score, based on widely available variables, that can be used to identify patients with PE at low risk of short-term complications, assisting in triage and potentially shortening duration of hospital stay.
OBJECTIVES: To develop and validate a clinical prediction rule that accurately identifies patients with PE and low risk of short-term complications and to compare its prognostic ability with two previously validated models (i.e., the Pulmonary Embolism Severity Index [PESI] and the Simplified PESI [sPESI])
METHODS: Multivariable logistic regression of a large international cohort of patients with PE prospectively enrolled in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry.
MEASUREMENTS AND MAIN RESULTS: All-cause mortality, recurrent PE, and major bleeding up to 10 days after PE diagnosis were determined. Of 18,707 eligible patients with acute symptomatic PE, 46 (0.25%) developed recurrent PE, 203 (1.09%) bled, and 471 (2.51%) died. Predictors included in the final model were chronic heart failure, recent immobilization, recent major bleeding, cancer, hypotension, tachycardia, hypoxemia, renal insufficiency, and abnormal platelet count. The area under receiver-operating characteristic curve was 0.77 (95% confidence interval [CI], 0.75-0.78) for the RIETE score, 0.72 (95% CI, 0.70-0.73) for PESI (P < 0.05), and 0.71 (95% CI, 0.69-0.73) for sPESI (P < 0.05). Our RIETE score outperformed the prognostic value of PESI in terms of net reclassification improvement (P < 0.001), integrated discrimination improvement (P < 0.001), and sPESI (net reclassification improvement, P < 0.001; integrated discrimination improvement, P < 0.001).
CONCLUSIONS: We built a new score, based on widely available variables, that can be used to identify patients with PE at low risk of short-term complications, assisting in triage and potentially shortening duration of hospital stay.
Pubmed
Create date
12/02/2016 13:43
Last modification date
03/06/2020 5:26
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