Prospective comparison of clinical prognostic scores in elderly patients with pulmonary embolism.

Détails

ID Serval
serval:BIB_F6088F1A4521
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prospective comparison of clinical prognostic scores in elderly patients with pulmonary embolism.
Périodique
Journal of Thrombosis and Haemostasis
Auteur(s)
Zwierzina D., Limacher A., Méan M., Righini M., Jaeger K., Beer H.J., Frauchiger B., Osterwalder J., Kucher N., Matter C.M., Banyai M., Angelillo-Scherrer A., Lämmle B., Egloff M., Aschwanden M., Mazzolai L., Hugli O., Husmann M., Bounameaux H., Cornuz J., Rodondi N., Aujesky D.
ISSN
1538-7836 (Electronic)
ISSN-L
1538-7836
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
10
Numéro
11
Pages
2270-2276
Langue
anglais
Résumé
Background: The Geneva Prognostic Score (GPS), the Pulmonary Embolism Severity Index (PESI), and its simplified version (sPESI) are well known clinical prognostic scores for pulmonary embolism (PE).Objectives: To compare the prognostic performance of these scores in elderly patients with PE. Patients/Methods: In a multicenter Swiss cohort of elderly patients with venous thromboembolism, we prospectively studied 449 patients aged ≥65 years with symptomatic PE. The outcome was 30-day overall mortality. We dichotomized patients as low- vs. higher-risk in all three scores using the following thresholds: GPS scores ≤2 vs. >2, PESI risk classes I-II vs. III-V, and sPESI scores 0 vs. ≥1. We compared 30-day mortality in low- vs. higher-risk patients and the areas under the receiver operating characteristic curve (ROC). Results: Overall, 3.8% of patients (17/449) died within 30 days. The GPS classified a greater proportion of patients as low risk (92% [413/449]) than the PESI (36.3% [163/449]) and the sPESI (39.6% [178/449]) (P<0.001 for each comparison). Low-risk patients based on the sPESI had a mortality of 0% (95% confidence interval [CI] 0-2.1%) compared to 0.6% (95% CI 0-3.4%) for low-risk patients based on the PESI and 3.4% (95% CI 1.9-5.6%) for low-risk patients based on the GPS. The areas under the ROC curves were 0.77 (95%CI 0.72-0.81), 0.76 (95% CI 0.72-0.80), and 0.71 (95% CI 0.66-0.75), respectively (P=0.47). Conclusions: In this cohort of elderly patients with PE, the GPS identified a higher proportion of patients as low-risk but the PESI and sPESI were more accurate in predicting mortality.
Pubmed
Web of science
Création de la notice
29/11/2012 17:55
Dernière modification de la notice
21/10/2019 20:56
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