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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 |
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container_title | European heart journal. Acute cardiovascular care |
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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 |
format | article |
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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<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<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><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary Embolism - etiology</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival Rate - trends</subject><subject>Venous Thromboembolism - complications</subject><subject>Venous Thromboembolism - diagnosis</subject><issn>2048-8726</issn><issn>2048-8734</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kL1PwzAQxS0EAlTYmZBHloC_YjtsqLRQqVDE1xq5jtO6JHGwEyFW_nJcFTogccud3v3uSfcAOMHoHGMhLghiUgrCsRRZLLoDDtdSIgVlu9uZ8ANwHMIKxRKIM0n3wQFFBFGeZofg61VVtlCddQ10JQy2bitbWlPAh9HTBAbtvIGl89AWpuniRm_Zyn0k3oY32EYpLgP8sN0Stn1Vu0b5T2jquatsqC_h2LsadksDh7O7u6v7a_j6PIKPZmFD5z-PwF6pqmCOf_oAvIxHz8PbZDq7mQyvpommIuuSOS2RkoTTUmupUi2Y4oygtMykSTNCdJSJwJjrTGLDMFVpyrhRPE0lIwWjA3C28W29e-9N6PLaBm2qSjXG9SEnGBFKkMxwRNEG1d6F4E2Zt97W8acco3wdfv43_Hhy-uPez2tTbA9-o45AsgGCWph85XrfxG__N_wGMFKLqw</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Yamashita, Yugo</creator><creator>Morimoto, Takeshi</creator><creator>Amano, Hidewo</creator><creator>Takase, Toru</creator><creator>Hiramori, Seiichi</creator><creator>Kim, Kitae</creator><creator>Oi, Maki</creator><creator>Akao, Masaharu</creator><creator>Kobayashi, Yohei</creator><creator>Toyofuku, Mamoru</creator><creator>Izumi, Toshiaki</creator><creator>Tada, Tomohisa</creator><creator>Chen, Po-Min</creator><creator>Murata, Koichiro</creator><creator>Tsuyuki, Yoshiaki</creator><creator>Saga, Syunsuke</creator><creator>Sasa, Tomoki</creator><creator>Sakamoto, Jiro</creator><creator>Kinoshita, Minako</creator><creator>Togi, Kiyonori</creator><creator>Mabuchi, Hiroshi</creator><creator>Takabayashi, Kensuke</creator><creator>Shiomi, Hiroki</creator><creator>Kato, Takao</creator><creator>Makiyama, Takeru</creator><creator>Ono, Koh</creator><creator>Kimura, Takeshi</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202006</creationdate><title>Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-b3f0a8263fcc8a5c74a64205f98e5922ccc827116c981e413a5546ea655842d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - epidemiology</topic><topic>Pulmonary Embolism - etiology</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Survival Rate - trends</topic><topic>Venous Thromboembolism - complications</topic><topic>Venous Thromboembolism - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal. 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<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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source | Oxford Journals Online |
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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