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Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry

Background: The simplified pulmonary embolism severity index (sPESI) score has been reported to be useful in predicting 30-day mortality for patients with pulmonary embolism, which helps the identification of low-risk patients for early hospital discharge or home treatment. However, therapeutic deci...

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Published in:European heart journal. Acute cardiovascular care 2020-06, Vol.9 (4), p.262-270
Main Authors: Yamashita, Yugo, Morimoto, Takeshi, Amano, Hidewo, Takase, Toru, Hiramori, Seiichi, Kim, Kitae, Oi, Maki, Akao, Masaharu, Kobayashi, Yohei, Toyofuku, Mamoru, Izumi, Toshiaki, Tada, Tomohisa, Chen, Po-Min, Murata, Koichiro, Tsuyuki, Yoshiaki, Saga, Syunsuke, Sasa, Tomoki, Sakamoto, Jiro, Kinoshita, Minako, Togi, Kiyonori, Mabuchi, Hiroshi, Takabayashi, Kensuke, Shiomi, Hiroki, Kato, Takao, Makiyama, Takeru, Ono, Koh, Kimura, Takeshi
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cited_by cdi_FETCH-LOGICAL-c379t-b3f0a8263fcc8a5c74a64205f98e5922ccc827116c981e413a5546ea655842d43
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container_title European heart journal. Acute cardiovascular care
container_volume 9
creator Yamashita, Yugo
Morimoto, Takeshi
Amano, Hidewo
Takase, Toru
Hiramori, Seiichi
Kim, Kitae
Oi, Maki
Akao, Masaharu
Kobayashi, Yohei
Toyofuku, Mamoru
Izumi, Toshiaki
Tada, Tomohisa
Chen, Po-Min
Murata, Koichiro
Tsuyuki, Yoshiaki
Saga, Syunsuke
Sasa, Tomoki
Sakamoto, Jiro
Kinoshita, Minako
Togi, Kiyonori
Mabuchi, Hiroshi
Takabayashi, Kensuke
Shiomi, Hiroki
Kato, Takao
Makiyama, Takeru
Ono, Koh
Kimura, Takeshi
description Background: The simplified pulmonary embolism severity index (sPESI) score has been reported to be useful in predicting 30-day mortality for patients with pulmonary embolism, which helps the identification of low-risk patients for early hospital discharge or home treatment. However, therapeutic decision-making should also be based on the risks of adverse events other than mortality. Methods: The COMMAND VTE Registry is a multicentre registry enrolling consecutive patients with acute symptomatic venous thromboembolism in Japan between January 2010 and August 2014, and the current study population consisted of 1715 patients with pulmonary embolism. We calculated the sPESI score for each patient, and compared 30-day rates of mortality, recurrent venous thromboembolism and major bleeding between sPESI scores of 0 and 1 or greater. Results: Patients with a sPESI score of 0 accounted for 383 (22%) patients, and 110 (6.4%) patients died within 30 days. The cumulative 30-day incidence of mortality was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (0.5% vs. 8.1%, log rank P
doi_str_mv 10.1177/2048872618799993
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However, therapeutic decision-making should also be based on the risks of adverse events other than mortality. Methods: The COMMAND VTE Registry is a multicentre registry enrolling consecutive patients with acute symptomatic venous thromboembolism in Japan between January 2010 and August 2014, and the current study population consisted of 1715 patients with pulmonary embolism. We calculated the sPESI score for each patient, and compared 30-day rates of mortality, recurrent venous thromboembolism and major bleeding between sPESI scores of 0 and 1 or greater. Results: Patients with a sPESI score of 0 accounted for 383 (22%) patients, and 110 (6.4%) patients died within 30 days. The cumulative 30-day incidence of mortality was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (0.5% vs. 8.1%, log rank P&lt;0.001). There was no significant difference in the cumulative 30-day incidence of recurrent venous thromboembolism between patients with a sPESI score of 0 and 1 or greater (1.3% vs. 2.8%, log rank P=0.11). The cumulative 30-day incidence of major bleeding was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (1.1% vs. 4.0%, log rank P=0.005). Conclusions: In patients with a sPESI score of 0, the 30-day mortality, recurrent venous thromboembolism and major bleeding rates were reasonably low. The sPESI score could be useful to identify candidates for early hospital discharge or home treatment.</description><identifier>ISSN: 2048-8726</identifier><identifier>EISSN: 2048-8734</identifier><identifier>DOI: 10.1177/2048872618799993</identifier><identifier>PMID: 30203659</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Incidence ; Japan - epidemiology ; Male ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - epidemiology ; Pulmonary Embolism - etiology ; Registries ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Severity of Illness Index ; Survival Rate - trends ; Venous Thromboembolism - complications ; Venous Thromboembolism - diagnosis</subject><ispartof>European heart journal. Acute cardiovascular care, 2020-06, Vol.9 (4), p.262-270</ispartof><rights>The European Society of Cardiology 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-b3f0a8263fcc8a5c74a64205f98e5922ccc827116c981e413a5546ea655842d43</citedby><cites>FETCH-LOGICAL-c379t-b3f0a8263fcc8a5c74a64205f98e5922ccc827116c981e413a5546ea655842d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30203659$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamashita, Yugo</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Amano, Hidewo</creatorcontrib><creatorcontrib>Takase, Toru</creatorcontrib><creatorcontrib>Hiramori, Seiichi</creatorcontrib><creatorcontrib>Kim, Kitae</creatorcontrib><creatorcontrib>Oi, Maki</creatorcontrib><creatorcontrib>Akao, Masaharu</creatorcontrib><creatorcontrib>Kobayashi, Yohei</creatorcontrib><creatorcontrib>Toyofuku, Mamoru</creatorcontrib><creatorcontrib>Izumi, Toshiaki</creatorcontrib><creatorcontrib>Tada, Tomohisa</creatorcontrib><creatorcontrib>Chen, Po-Min</creatorcontrib><creatorcontrib>Murata, Koichiro</creatorcontrib><creatorcontrib>Tsuyuki, Yoshiaki</creatorcontrib><creatorcontrib>Saga, Syunsuke</creatorcontrib><creatorcontrib>Sasa, Tomoki</creatorcontrib><creatorcontrib>Sakamoto, Jiro</creatorcontrib><creatorcontrib>Kinoshita, Minako</creatorcontrib><creatorcontrib>Togi, Kiyonori</creatorcontrib><creatorcontrib>Mabuchi, Hiroshi</creatorcontrib><creatorcontrib>Takabayashi, Kensuke</creatorcontrib><creatorcontrib>Shiomi, Hiroki</creatorcontrib><creatorcontrib>Kato, Takao</creatorcontrib><creatorcontrib>Makiyama, Takeru</creatorcontrib><creatorcontrib>Ono, Koh</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><title>Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry</title><title>European heart journal. Acute cardiovascular care</title><addtitle>Eur Heart J Acute Cardiovasc Care</addtitle><description>Background: The simplified pulmonary embolism severity index (sPESI) score has been reported to be useful in predicting 30-day mortality for patients with pulmonary embolism, which helps the identification of low-risk patients for early hospital discharge or home treatment. However, therapeutic decision-making should also be based on the risks of adverse events other than mortality. Methods: The COMMAND VTE Registry is a multicentre registry enrolling consecutive patients with acute symptomatic venous thromboembolism in Japan between January 2010 and August 2014, and the current study population consisted of 1715 patients with pulmonary embolism. We calculated the sPESI score for each patient, and compared 30-day rates of mortality, recurrent venous thromboembolism and major bleeding between sPESI scores of 0 and 1 or greater. Results: Patients with a sPESI score of 0 accounted for 383 (22%) patients, and 110 (6.4%) patients died within 30 days. The cumulative 30-day incidence of mortality was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (0.5% vs. 8.1%, log rank P&lt;0.001). There was no significant difference in the cumulative 30-day incidence of recurrent venous thromboembolism between patients with a sPESI score of 0 and 1 or greater (1.3% vs. 2.8%, log rank P=0.11). The cumulative 30-day incidence of major bleeding was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (1.1% vs. 4.0%, log rank P=0.005). Conclusions: In patients with a sPESI score of 0, the 30-day mortality, recurrent venous thromboembolism and major bleeding rates were reasonably low. 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Acute cardiovascular care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamashita, Yugo</au><au>Morimoto, Takeshi</au><au>Amano, Hidewo</au><au>Takase, Toru</au><au>Hiramori, Seiichi</au><au>Kim, Kitae</au><au>Oi, Maki</au><au>Akao, Masaharu</au><au>Kobayashi, Yohei</au><au>Toyofuku, Mamoru</au><au>Izumi, Toshiaki</au><au>Tada, Tomohisa</au><au>Chen, Po-Min</au><au>Murata, Koichiro</au><au>Tsuyuki, Yoshiaki</au><au>Saga, Syunsuke</au><au>Sasa, Tomoki</au><au>Sakamoto, Jiro</au><au>Kinoshita, Minako</au><au>Togi, Kiyonori</au><au>Mabuchi, Hiroshi</au><au>Takabayashi, Kensuke</au><au>Shiomi, Hiroki</au><au>Kato, Takao</au><au>Makiyama, Takeru</au><au>Ono, Koh</au><au>Kimura, Takeshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry</atitle><jtitle>European heart journal. Acute cardiovascular care</jtitle><addtitle>Eur Heart J Acute Cardiovasc Care</addtitle><date>2020-06</date><risdate>2020</risdate><volume>9</volume><issue>4</issue><spage>262</spage><epage>270</epage><pages>262-270</pages><issn>2048-8726</issn><eissn>2048-8734</eissn><abstract>Background: The simplified pulmonary embolism severity index (sPESI) score has been reported to be useful in predicting 30-day mortality for patients with pulmonary embolism, which helps the identification of low-risk patients for early hospital discharge or home treatment. However, therapeutic decision-making should also be based on the risks of adverse events other than mortality. Methods: The COMMAND VTE Registry is a multicentre registry enrolling consecutive patients with acute symptomatic venous thromboembolism in Japan between January 2010 and August 2014, and the current study population consisted of 1715 patients with pulmonary embolism. We calculated the sPESI score for each patient, and compared 30-day rates of mortality, recurrent venous thromboembolism and major bleeding between sPESI scores of 0 and 1 or greater. Results: Patients with a sPESI score of 0 accounted for 383 (22%) patients, and 110 (6.4%) patients died within 30 days. The cumulative 30-day incidence of mortality was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (0.5% vs. 8.1%, log rank P&lt;0.001). There was no significant difference in the cumulative 30-day incidence of recurrent venous thromboembolism between patients with a sPESI score of 0 and 1 or greater (1.3% vs. 2.8%, log rank P=0.11). The cumulative 30-day incidence of major bleeding was lower in patients with a sPESI score of 0 than those with a sPESI score of 1 or greater (1.1% vs. 4.0%, log rank P=0.005). Conclusions: In patients with a sPESI score of 0, the 30-day mortality, recurrent venous thromboembolism and major bleeding rates were reasonably low. The sPESI score could be useful to identify candidates for early hospital discharge or home treatment.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>30203659</pmid><doi>10.1177/2048872618799993</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Incidence
Japan - epidemiology
Male
Pulmonary Embolism - diagnosis
Pulmonary Embolism - epidemiology
Pulmonary Embolism - etiology
Registries
Retrospective Studies
Risk Assessment - methods
Risk Factors
Severity of Illness Index
Survival Rate - trends
Venous Thromboembolism - complications
Venous Thromboembolism - diagnosis
title Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry
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