Performance of pulmonary embolism severity index in predicting long-term mortality after acute pulmonary embolism

• Published in: Anatolian journal of cardiology 2021-08, Vol.25 (8), p.544-554
• Main Authors: Sandal, Abdulsamet, Korkmaz, Elif Tuğçe, Aksu, Funda, Köksal, Deniz, Toros Selçuk, Ziya, Demir, Ahmet Uğur, Emri, Salih, Çöplü, Lütfi
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Female; Humans; Male; Original Investigation; Prognosis; Pulmonary Embolism; Retrospective Studies; Risk Assessment; Severity of Illness Index
• ISSN: 2149-2263; 2149-2271
• DOI: 10.5152/AnatolJCardiol.2021.99345

In this study, we aimed to evaluate the accuracy of the original and simplified pulmonary embolism (PE) severity index (PESI) to predict all-cause mortality after 30 days of acute PE diagnosis up to five years within consecutive sub-periods. Adult patients diagnosed with acute PE between January 1, 2003, and June 30, 2013, were retrospectively included. Data on baseline characteristics and mortality during a five-year follow-up were collected. The study included 414 patients (Male/Female=192/222). The median age at diagnosis was 61.5 (minimum-maximum, 18-93) years. Mortality rates were 13.3% at 30 days, 21.8% at 90 days, 32.6% at one year, and 51.0% at five years. Both stratification into risk classes according to the original PESI and low vs. high-risk classification of original and simplified PESI were significantly correlated with the 30-day, 31-90-day, 91-day-one-year, and one-five-year mortality. Significant PESI predictors for mortality were history of cancer [hazard ratio (HR): 3.31, 95% confidence interval (CI): 1.64-6.68; p=0.001] and heart failure (HR: 2.35, 95% CI: 1.04-5.32, p=0.041) at 31-90-day, history of cancer (HR: 5.45, 95% CI: 2.86-10.40, p